Giant myomas, defined as those > 9 cm, are uncommon. Due to the difficulties caused by its enormous size, the usual surgical treatment is a simple total hysterectomy. The surgery may be performed by either laparoscopy or laparotomy. However, the case presents a 45-year-old woman who was diagnosed with a giant myoma of 23 cm. The patient is asymptomatic and does not accept the indication of a simple total hysterectomy because of her fear to lose her femininity and a feeling of mutilation and unfulfilled genesic desire. A personalized procedure was performed: myomectomy by laparotomy with subsequent uterine reconstruction. The case is described to focus the interest on giant uterine myomas, taking into account the limited availability of literature on the topic, and to highlight the reconstruction after myomectomy.