Objective: Present an unusual case Target: Adanced practicioners Methods: Background and Aims: We present a case of iatrogenic gastric perforation caused by umbilical trocar insertion with subsequent laparoscopic primary repair. Design: Case study. Patients: A 58-year-old Korean woman with no history of abdominal surgery was scheduled to undergo a laparoscopic assisted vaginal hysterectomy for myoma ureti. Interventions: Laparoscopy. Results: A 58-year-old Korean woman had a laparoscopic assisted vaginal hysterectomy on June 26, 2019. During abdominal entry, a 5-mm trocar was then placed by direct trocar insertion method, but introduction of the laparoscope revealed that it had been placed within the lumen of the stomach. We inserted nasogastric tube to remove gas and liquid from the stomach. The stomach perforation, which had been marked by leaving the original trocar in place and appeared to be an 5-mm clean injury with minimal bleeding The perforation site was repaired laparoscopically with 2-0 vicryl sutures, using intracorporeal interrupted full-thickness suture. Her nasogastric tube was removed on postoperative day one. The patient did well postoperatively and recovered without complications. Conclusion: Our experience indicate that laparoscopic primary repair of gastric perforation caused by umbilical trocar insertion is safe and feasible.