Objective: The management of a lost abdominal intrauterine contraceptive device (IUD) is discussed together with a review of the relevant literature. The case: The IUD is one of the most commonly used, effective, cheap and safe methods of contraception in Turkey. However, IUD insertion may result in uterine perforation which may lead to a variety of abdominal complications or can remain asymptomatic in the abdomen for a long time without causing any complications. An asymptomatic case of a woman with an IUD inserted 42 years before is presented. To the best of our knowledge this is the longest time an IUD (found by X-ray) has been localized in the abdomen. Conclusion: We suggest that in asymptomatic patients with an IUD localized in the abdomen, the risks of both operating and not operating should be discussed thoroughly and in such cases, follow-up without surgery may be considered as an alternative approach.;">