BACKGROUND: Intrauterine device (IUD) perforation of the bowel is uncommon. Although IUD perforation may be asymptomatic, the most common complaint is unexplained abdominal pain. CASE: A case of IUD peiforation of the larc, bozvel zuas ge diagnosed 7 years after insertion. The patient presented ivith unexplained lozver abdominal pain diagnosed initially as pelvic inflammatory disease. Laparoscopy revealed that the IUD was embedded deeply in the rectum. Bowel preparation and intravenous antibiotics followed by colonoscopy using a grasping snare resulted in successful IUD removal. CONCLUSION: Patients presenting with IUDs embedded in the large bowel inay benefit from attempted removal using colonoscopy rather than laparotomy. Bowel preparation, intravenous antibiotics and postextraction evaluation to rule out perforation inay be prudent.