Background: Rectal injuries are the most severe complications of gynecologic surgeries, especially total laparoscopic hysterectomy. In several cases, an ileostomy is performed as a lifesaving procedure. Recently, studies have suggested that primary repair should be attempted for all cases of intraperitoneal rectal injuries. To the best of our knowledge, previous case reports have not discussed the specific repair of a rectal injury involving all layers. Case: We report a case of rectal perforation during total laparoscopic hysterectomy and bilateral salpingo-oophorectomy that was laparoscopically repaired using an automatic anastomosis device. Conclusions: A rectal injury may be repaired laparoscopically if the bowel is adequately prepared preoperatively and a skilled surgeon is present.