Obstetric vesicovaginal fistula is a tragic injury that is widespread in any country where access to emergency obstetric care is limited. More and more people are now interested in treating and caring for these women, but little is known about surgical management, and most operators have developed their own methods through years of experience. One of the more challenging cases to get a functional repair is in those women who have a circumferential defect in the bladder/urethra. This article analyses a series of 77 consecutive circumferential obstetric fistula cases operated in the Barhirdar Hamlin Fistula Centre by the author.