We would like to present a case of a 37 year old grand multiparous woman, in whom we placed her sixth cervical cerclage, laparoscopically.  This was her third laparoscopic cerclage in a complicated history of pregnancy loss and repeated interval and rescue suture placements, we look at the missing piece of the jigsaw in relation to cervical incompetence.  Undoubtedly part of a syndrome complex this condition continues to baffle, why would a high, tight suture not secure a pregnancy?  In addition to the case history and video footage of the revision laparoscopic cerclage, we will discuss the  current immunological evidence on cervical incompetence, to endeavour to shed light on the reasons why a secure, well positioned suture is sometimes, not enough.