Sixty six patients who had rupture of the pregnant uterus were studied in Saidu Group of Hospital, Swat from Jan 2001 to Dec 2001. Aim was to find out the incidence and predisposing factors of rupture uterus in an area where healthcare facilities are inadequate and not easily accessible because of the geographical conditions. Hospital incidence was 12.5 per 1000 deliveries, higher than most other studies. it was found to be responsible for 15.8% of total maternal deaths in teh unit. Among the etiologic and predisposing factors the most important were obstructed labor and injudicious use of oxylocin by untrained people. 23% were due to rupture of previous scar, again mostly handled at home. Multiparty was an important risk factor; 74% of the patients had parity of 5 or high 74% of the patient had total or subtotal hysterectomy, in 4.5% of them bladder was also repaired. 26% of the patients had reapir of the ruptured uterus and 7.6% of them had bilateral tubal ligation.