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TOPIC: A RARE PRESENTATION OF LARGE UTERINE FIBROID PRESENTER: DR. SHREYA JAIN INTRODUCTION Uterine fibroids, benign growths in women, can vary in size and often remain untreated unless symptomatic. This case discusses a neglected yet intriguing instance of a giant fibroid uterus. *Aim:* To present and analyze a giant uterine fibroid case, emphasizing clinical significance and management. *Objectives:* Describe diagnosis, evaluate untreated growth patterns, discuss treatment options, raise awareness of monitoring asymptomatic fibroids, and contribute to literature on rare fibroid cases for educational purposes. Materials and methods This case report focuses on a 35-year-old woman with a giant uterine fibroid. Diagnostic imaging was performed using high-frequency ultrasonography and MRI to evaluate fibroid size, location, and characteristics. A thorough clinical assessment included medical history, physical examination, and laboratory tests. Treatment options were discussed, emphasizing surgical interventions like myomectomy or hysterectomy, based on patient preferences and risks. Follow-up appointments were scheduled to monitor symptoms ,with outcomes recorded for further analysis. Results Imaging revealed a solitary giant uterine fibroid measuring 24cm. The patient experienced abdominal distension and mild discomfort, but hemoglobin levels remained normal, indicating no acute anemia. After discussing treatment options, the patient chose total abdominal hysterectomy with bilateral salpingoopherectomy The surgery was successful, with complete fibroid removal. Postoperative follow-up showed resolution of symptoms and no recurrence at six months. The patient reported improved quality of life and no further complications. Conclusion Atypical presentations of fibroids can be confusing, as they may grow to significant sizes, as seen in this case. Giant uterine tumors can cause varied clinical manifestations depending on affected surrounding organs. A combined effort involving gynecologists, general surgeons, and plastic surgeons is essential for optimal outcomes, ensuring comprehensive management and improved patient quality of life in such complex situations.