Cesarean hysterectomy is an uncommonly performed, but lifesaving operation, usually for massive hemorrhage. One of the criticisms of family medicine physicians practicing obstetrics is that they are not trained in cesarean hysterectomy should the occasion arise. Unfortunately, newly graduated OB/GYN physicians, likely, have rarely performed a cesarean hysterectomy either. Even seasoned OB/GYNs may not have performed the procedure for quite some time. This paper describes a straightforward approach to cesarean hysterectomy that family medicine physicians practicing obstetrics or newly graduated OB/GYN physicians can perform. Following this description is a case report of a cesarean section hysterectomy performed by an obstetrics fellowship trained family medicine physician with a general surgeon for a ruptured uterus in a rural hospital without a labor and delivery unit or nursery. Both mother and baby survived.