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Hysteroscopy dilatation and curettage is a common minor gynaecological procedure utilised for diagnostic or therapeutic purposes. A 62-year-old woman underwent a hysteroscopy, dilatation and curettage for investigation of prolonged post-menopausal bleeding. Unexpected uterine haemorrhage was encountered without evidence of uterine perforation causing haemodynamic instability. A thrombotic microangiopathy was triggered, leading to microangiopathic haemolytic anaemia, thrombocytopaenia and evidence of micro-thrombosis causing stroke and end-organ dysfunction, including acute renal failure. The histopathology confirmed stage 1 endometrioid adenocarcinoma. This is the first case report of a thrombotic microangiopathy leading to microangiopathic haemolytic anaemia in a patient with endometrioid adenocarcinoma FIGO grade 1, stage 1B following a minor gynaecological procedure.