Management of uterine fibroids is common in day today practice of gynaecologists, but a large haemorrhagic leiomyoma with axial torsion of uterus is a rare occurrence. We report a case of 52-year old female presented with abdominal distension and pain. An enlarged twisted haemorrhagic uterus was identified at laparotomy which was successfully removed. Histopathological examination showed a benign leiomyoma with focal congestion. The patient had an uneventful postoperative recovery.