INTRODUCTION: Rectovaginal tears are usually associated with the insertion of foreign bodies, accidental trauma, and nonconsensual intercourse.AIM: The aim of this study was to describe an extremely rare case of extensive rectovaginal tear as a result of consensual vaginal and anal intercourse.METHODS: A case is presented along with review of the literature.RESULTS: A 20-year-old woman presented with acute perineal pain and minor vaginal bleeding following consensual vaginal and anal intercourse. No insertion of sex toy or any other object was reported. Vaginal and rectal examination revealed a ruptured posterior vaginal wall with wide communication with the rectum, without involvement of the anal sphincters. Surgical treatment with primary repair of the tear and diverting colostomy was performed.CONCLUSIONS: Although consensual intercourse is usually associated with minor genital trauma, rare but potentially serious injuries can occur. Clinicians should be aware of the possibility of such injuries because failure to identify them can lead to delayed treatment and poor outcome.