Uterine rupture is rare but one of the most severe and fatal complications in obstetrics. Nonetheless, its presence in the second trimester is exceptionally rare, posing considerable difficulties for diagnosis and management. This case report demonstrates a 38-year-old woman with a history of a previous cesarean delivery who presented at 18 weeks of gestation at the emergency department with severe, acute onset abdominal pain at the right iliac fossa. The patient underwent surgery due to high suspicion, and incomplete uterine rupture was revealed and managed appropriately. Following the surgery, the patient was admitted to the hospital for close monitoring, and at 37 weeks, a successful cesarean delivery resulted in the birth of a live male infant. This case highlights that the obstetric team should remain alert to recognize early the signs and symptoms of this complication in patients with a history of uterine surgery and, as a result, to achieve an optimal perinatal outcome. Specific management and monitoring algorithms could aid the obstetric team in optimally treating these patients.