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TITLE- An atypical case of vesicular transmigration of IUCD. Dr.Sudhir Kumar Deep(PG), Dr. Abhishek Kujur, SCBMCH, Cuttack Odisha. INTRODUCTION - IUCD is best known contraceptive device for its longevity, effectivity, and reversibility. It is safe but complications may occur like abnormal uterine bleeding, infection, expulsion, failure and rarest of all, migration into adjacent pelvic structures. This case aims to describe an unusual occurance of vesicular transmigration of IUCD. Case Reports - A 37 year old female P2L2 came to our hospital with complain of frequency, urgency of urination, intermittent straining, dysuria since 8 months, there was no history of hematuria or pyuria. On examination patient was vitally stable, per abdomen was soft nontender, Per speculum IUCD thread visible through external Os. Patient was advised USG pelvis and urology consultation. USG pelvis and X-ray abdomen and pelvis suggested IUCD perforating anterior wall of uterus and posterior wall of urinary bladder causing foreign body granuloma in urinary bladder, with calculus of size 20 mm in urinary bladder lumen. After proper evaluation she was operated , cystoscopy done , calculus with vertical segment of IUCD (CuT380-A) removed by performing cystolithotripsy and vaginally dilation of cervix done, through hysteroscopy horizontal segment of IUCD removed. Foley's catheterization was done for 3weeks .patient was successfully discharged .on follow up she had gradual improvement in her urinary symptoms , foleys catheter was removed and she got her menses after 3 weeks. CONCLUSION - This case illustrates a rare entity and a rare complication that can be considered while managing urinary symptoms with history of IUCD , more with missing devices. Previous uterine surgery may trigger the process of migration of IUCD. USG, full urinary bladder scan and X-ray abdomen is sufficient to locate the migrated IUCD. The endoscopic approach for removal is considered safe and effective.