Herniated gravid uterus in an incisional hernia of the anterior abdominal wall is relatively rare. A 30-year-old house wife presented with a six month gravid uterus that had herniated through an incisional hernia of the anterior abdominal wall. She had non-operative management till term, when she then had elective lower caesarian section. Physiotherapy of the anterior abdominal wall muscles to improve their tone was done. She subsequently had keel’s repair of the hernia. Aggressive physiotherapy of the anterior abdominal wall muscles followed by keel’s repair may be an alternative surgical technique in patients with a moderate defect of incisional hernia