Our objective is to demonstrate that moderate size type 2-4 fibroids should be removed with laparoscopic myomectomy. The use of 3D ultrasound imaging to accurately identify size and position of fibroid is essential, since it guides operative strategy especially when hysteroscopic evaluation of the submucosal fibroid component may give a false impression of its size and transcervical resection feasibility. We present a video demonstration of the diagnostic sequence and then laparoscopic myomectomy in simple steps. In conclusion, robust pre-operative assessment is necessary to avoid transcervical fibroid resections requiring prolonged operative time or multiple sessions.