Uterine fibroids are fairly common entity, but it is rare to find a subserous fibroid with a pedicle (stalk). As these fibroid grow larger they can become twisted, resulting in severe pain. They get separated from the uterus and are mistaken for adnexal mass. Diagnosis of pedunculated leiomyoma can be established by ultrasound which shows palpable mass separate from uterus and ovaries. They become parasitic after developing auxiliary blood supply. In elective cases, diagnostic laparoscopic examination before laparotomy can be useful.