NTRK-rearranged sarcoma of the cervix was recognized by the World Health Organization in 2020 as an emerging tumor entity under mesenchymal tumors of the lower female genital tract. Defined by characteristic NTRK gene fusions, this rare tumor is therapeutically targetable due to same. We report a case of a 23-year-old woman who presented with abnormal vaginal bleeding and a polypoid cervical mass. Histopathological examination of preliminary biopsy revealed spindle cell sarcoma demonstrating immunopositivity for Pan-TRK, CD34, and S100. Break-apart fluorescence in situ hybridization (FISH) confirmed the presence of an NTRK3 gene rearrangement. This patient represents one of the few reported cases of NTRK3-rearranged cervical sarcoma with lymph node metastasis in a young female. We also extensively review the existing literature and summarize the clinicopathological features, molecular profiles, and treatment implications of this report. Given the availability of effective TRK inhibitors, it is imperative to consider NTRK-rearranged sarcoma in the differential diagnosis of spindle cell sarcomas of the lower genital tract.