Most obstetricians try to avoid myomectomy during caesarean section due to associated risks of haemorrhage. Leaving them is not entirely without complications. We report a rare case of spontaneous expulsion of a large fibroid following caesarean section.Keywords Fibroids . Myomectomy . Caesarean myomectomy . Expulsion of fibroids Case reportA 35-year-old woman had a booking scan which suggested a single intra-uterine pregnancy with a 6-cm fibroid in the posterior wall of the uterus. Pregnancy was uneventful in first and second trimester. A repeat scan in second trimester showed increase in size of the fibroid. She went into preterm labour at 34 weeks of gestation and had an emergency caesarean section for mal-presentation. The fibroid in the posterior wall was about 12 cm in size and was left untouched. Post-operative recovery was uneventful and she was discharged home on day 5. She presented to gynaecology assessment unit at 6 weeks post-partum with complaints of persistent foul smelling vaginal discharge for 3 weeks and difficulty in passing urine for 2 days. She gave history of severe cramps in her pelvis 4 days prior to her presentation.Her observations were stable and abdominal examination revealed a distended bladder, catheterisation drained 800 ml of urine and a palpable 20-week uterus was noted.