Introduction: Uterine fibroids are the most common benign pelvic tumors in women of reproductive age. Most of them are asymptomatic but they are also a major source of clinical morbidity. Aim: We present this case due to its uniqueness and the diagnostic difficulties it posed. Case Report: A 40-year-old female presented to the OPD with complaints of pain abdomen on and off and heavy menstrual bleeding. Physical examination revealed a lump of 14-week size.USG and CT scan revealed intramural fibroid with cystic/mucoid degeneration. The patient had an elective total abdominal hysterectomy with bilateral scalping-oophorectomy. Intraoperatively uterus was enlarged with hydrosalpinx on the right side. Histopathological examination showed mucoid degeneration of fibroid with chronic cervicitis. Discussion: Degenerating changes in fibroids are considered to result from excessive growth that outmatches the blood supply or mechanical compression of feeder arteries. Conclusion: This case illustrates that degeneration of uterine leiomyoma should be considered as one of the differential diagnoses for all women presenting with abdominal pain and a large fibroid mass regardless of hormonal status or age.