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Inevitable caesarean myomectomy: our success story Introduction: Uterine fibroids occur in 20?40% of women in reproductive age and the prevalence of uterine fibroids in pregnant woman ranges from 1% to 10.7%. The incidence is rising due to delayed childbearing. Uterine fibroid in pregnancy is usually asymptomatic with complications occurring in 10?30% of cases. Uterine fibroids can cause complications such as spontaneous abortion, placental abruption, antepartum haemorrhage, fetal malpresentation, preterm birth, premature rupture of membranes, need of caesarean section and postpartum haemorrhage. Elective myomectomy at the time of caesarean section is discouraged, at times, myomectomy is mandatory to effect delivery during caesarean section. Case: Caesarean myomectomy in primigravida at 35 wks with large 24 cm fibroid replacing lower uterine segment and cervix. The outcome was a live female baby with a birth weight of 1.8?kg and a large fibroid weighing 2.7?kg. Keywords: Fibroid, Pregnancy, Myomectomy