Background: Choriocarcinoma is a rare but significant component of Gestational Trophoblastic Diseases (GTD) that presents diagnostic challenges due to its varied symptoms. Early diagnosis of choriocarcinoma is crucial for prompt treatment and favorable outcomes. Case Report: In this case report, we present the case of a 26-year-old patient who presented in a state of hypovolemic shock with severe anemia and hypotension. Upon further evaluation, the patient was found to have choriocarcinoma, which had perforated her uterus causing a spontaneous uterine rupture. Unfortunately, the patient had delayed diagnosis due to lack of consideration for urine pregnancy test and beta HCG levels after a previous spontaneous abortion with dilatation and curettage. Conclusion: This case highlights the importance of considering choriocarcinoma in the differential diagnosis of women presenting with abnormal uterine bleeding following any obstetric event. A high degree of suspicion for GTD should be kept in mind to allow for prompt diagnosis and treatment. Therefore, performing a cost-effective urine pregnancy test and beta HCG estimation if UPT is positive is essential for early diagnosis and to prevent morbidity and mortality associated with choriocarcinoma.