We report 386 consecutive cases of uterine rupture over a 10-year period, revealing a case fatality rate of 4.8%, which is significantly less than the 16–37% fatality rate published in the literature. Primary uterine repair, which was carried out by non-specialised doctors in 43% of cases, was the treatment for 98% of women, and appears to be simple and effective. The main predictor of death from uterine rupture was a treatment delay of more than 12 hours from the presumed time of rupture (OR 7.7; 95% CI 1.02–58.4).