Background: Uterine carcinosarcoma often presents with significant uterine distention. This makes it difficult to perform minimally invasive surgery, which is preferred for uterine cancer given the significant recovery benefits. Cases: We present two cases of uterine carcinosarcoma in which we performed uterine evacuation intraoperatively to decompress the uterine volume to facilitate specimen removal through the vagina. The first patient ultimately had stage IA disease. She received adjuvant chemotherapy and radiation and has remained disease-free for 2 years. The second patient had stage IVB disease on final pathology report. She received adjuvant chemotherapy but had disease recurrence 4 months after completion of treatment. Conclusion: Intraoperative uterine evacuation during surgery for uterine carcinosarcoma may make possible a minimally invasive procedure in patients with large, distended uteri.