Vesico-utero-sigmoid fistula secondary to an encrusted, transmigrated intrauterine contraceptive device (IUCD) to the urinary bladder is a rare urogenital occurrence. Reported here is a case of a 42-year-old female with 13 years of IUCD presenting with a two-year history of terminal dysuria, occasional hematuria and urinary dribbling. In the interim, she complained of persistent wet stools, pneumaturia, fecaluria and occasional urinary incontinence. Imaging revealed an encrusted IUCD with a concomitant vesico-utero-sigmoid fistula. Patient underwent a single setting colonoscopy, vagino-hysteroscopy, cystoscopy with cystostomy and extraction of encrusted foreign body (IUCD), excision and primary repair of vesico-utero-sigmoid fistula was done. The surgery proved successful, greatly improving the patient’s quality of life. This is the first reported case of a vesico-utero-sigmoid fistula caused by a foreign body both in local and international literature.