Objective: To evaluate risk factors, management and pregnancy outcome of patients with uterine rupture at tertiary care hospital, Nawabshah. Methodology: It was prospective observational study conducted in Obstetric and Gynaecological department of Peoples University of Medical and Health Sciences For Women, Nawabshah From 1st July 2010 to 30th June 2012.All patients diagnosed as case of intrapartum uterine rupture were approached. A pre-designed proforma was used to collect the demographic features, predisposing risk factors, management and fetomaternal outcome. Data was fed to SPSS programme version 16 to analyze results. Results: Total maternity admission were11732 with 9698 deliveries. A total number of 50 cases of uterine rupture were identified, giving a frequency of 0.5 or1:194 deliveries. There were 30 (60%) cases in scarred and 20(40%) cases in un scarred uteri. Highest incidence was found in age group 21-30 years (54%), in multigravida 25(50%), unbooked (92%), 90% were the referred cases. Scarred uterus (60%), injudicious use of oxytocics27(54%), grandmultiparity 22(44%) and obstructed labour 16(32%) were found as main predisposing factors. Uterine repair was done in 72% of cases while hysterectomy was performed in 28% cases. Bladder repair was additionally required in 10% of cases. Observed morbidities were as follows: 25(50%) were in a state of shock, 20(40%) had anemia, 15(30%) had puerperal sepsis, 5(10%) had wound infection, 2(10%) in disseminated intravascular coagulation and 2(4%) had vasicovaginal fistula. There were 4(8%) maternal and 47(94%) perinatal deaths due to uterine rupture. Conclusion: Uterine rupture is yet a common obstetrical emergency in our area and is a major risk for maternal and perinatal morbidity and mortality. Proper antenatal care, early referral of women at risk, awareness for supervised deliveries and careful selection of patient for vaginal delivery and repeat caesarean section in parturients with previous uterine scar especially when labour fail to progress, not only reduce this drastic obstetrical complication but also improve maternal and perinatal mortality.