Objective Innovatively performing a C1 nerve-sparing radical hysterectomy with sentinel node resection for cervical cancer via vaginal Natural Orifice Transluminal Endoscopic Surgery (v-NOTES), investigating the technical points and advantages. Methods A patient with early-stage cervical adenocarcinoma was treated by a C1 radical v-NOTES hysterectomy with bilateral sentinel node lymphadenectomy and bilateral salpingo-oophorectomy. Right pelvic nerve plexus was reserved during the operation. The surgical procedure and the patient's postoperative recuperation were documented. Results The radical v-NOTES hysterectomy went well, without conversion to open surgery. Intraoperative bleeding was less and no peripheral organs was damaged during surgery. The patient recovered well after the operation and showed no complications. Conclusion v-NOTES enables a new approach to radical hysterectomy of cervical cancer, with characteristics of little damage and rapid recovery, possessing potential for further promotion.