A case report of a live birth following a term pregnancy located in a non‑communicating rudimentary horn of a unicornuate uterus in a rural hospital in Nigeria is presented. A 32‑year‑old primiparous woman registered for antenatal care at a rural missionary hospital at 28 weeks gestation. She had intermittent unexplained vaginal bleeding prior to booking and multiple ultrasound scans in different centers affirmed a viable intrauterine pregnancy. She had an elective cesarean section at 38 weeks gestational age on account of a persistent oblique breech presentation and “low lying placenta.” Intra‑operatively, the pregnancy was found in a non‑communicating pouch continuous with the left fallopian tube and separate from the uterine cavity. A female baby weighing 2.2 kg with no gross deformity was delivered. Resection of the rudimentary horn and repair were done. The possibility of a uterine anomaly should be considered by clinicians and sonographers in unexplained intermittent early pregnancy bleeding.