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? Introduction (30 words) : - Uterine fibroids are the commonest benign tumour which affect reproductive age women. .Pseudo Meigs? syndrome with isolated pericardial effusion is a rare finding in case of uterine fibroid. Surgical management of large fibroid uterus create multiple challenges to both surgeon and the patient. ? Aims & Objectives (40 words): We present a case of pseudo Meigs? syndrome in a 36 weeks size intramural uterine fibroid with isolated pericardial effusion. Management was done with myomectomy and total abdominal hysterectomy through a pfannenstiel incision ? Results (80 words): resolving pericardial effusion after successful myomectomy f/b total abdominal hysterectomy through a pfannenstiel incision. ? Conclusions (70 words): Pericardial effusion seems to be resolving after Successful myomectomy and hysterectomy. Management of fibroid uterus depends of patient?s age, fertility wishes, uterine preserving desires, symptomatology, site and size of fibroids. Successful myomectomy and hysterectomy can be done through a pfannenstiel incision even for a 36 weeks size fibroid uterus in carefully selected patients.