Introduction: Labial fusion is described as partial or complete adherence of the labia minora. Adhesions of the labia are extremely rare in the reproductive population with only a few cases described in the literature and none reported with pregnancy. Case presentation: A 24-year-old woman who had extensively fused labia with a pinhole opening at the upper midline with menstrual delay was diagnosed at six weeks of pregnancy. The case and its management are presented. Conclusion: The condition was treated surgically with complete resolution of the urinary symptoms.