Hysteroscopy is widely used for the detection and treatment of intrauterine adhesion. Such technique, however, sometimes has limitations and even second damages. We report a rare case of severe intrauterine adhesion caused by uterine perforation with a fallopian tube incarceration. A 24-year-old woman underwent severe intrauterine adhesion and secondary infertility caused by fallopian tube incaceration into the uterine cavity after postpartum curettage. First hysteroscopy created a false passage through the previous uterine perforation, entered into the cavity of incarcerated fallopian tube, and led to iatrogenic hydrosalpinx. Secondary hysteroscopy combined with laparoscopy revealed a connection between the right tubal lumen and the uterine cavity by the false passage, released the adhesion, and reconstructed the uterine cavity. Early recognition of uterine perforation or tissue incarcerarion is significant in preventing further damage.