Currently, there is an increasing number of patients suffering from fibroid disease. Many of them do not cause any discomfort to the patients and are not treated. However, there are some patients who have large fibroids, more fibroids, or fibroids that grow in special places and cause symptoms such as heavy menstruation, prolonged menstruation, lower abdominal distension and pain, or in severe cases, severe anemia and changes in urinary and bowel habits. Clinically, we usually call fibroids with a diameter of more than 8-10 cm “giant fibroids”. The fast-growing fibroids have the possibility of malignant transformation, therefore, active surgery is recommended. In addition, surgery is also recommended for fibroids that grow in specific areas, such as submucosal fibroids, cervical fibroids, and broad ligament fibroids. Surgical treatment is also recommended for interstitial or subplasmic myomas with a diameter of 5 cm or more. So, what are those surgical procedures in general? Myomectomy, subtotal hysterectomy, total hysterectomy, etc. The access can be transvaginal, open, or laparoscopic. Currently, laparoscopic surgery is more common, but it has certain contraindications, such as: severe pelvic adhesions, patient’s physical condition is not suitable for laparoscopic surgery, etc. Can laparoscopic surgery be performed for larger or multiple uterine fibroids? The answer is yes, some uteruses as large as 5-6 months of pregnancy can still be operated laparoscopically. The key is the availability of space to operate bilaterally next to the uterus at the time of examination and the surgical ability of the surgeon, etc. Of course if malignancy is suspected it is better to have open surgery or myoma not to be crushed with a rotary cutter and to open a slightly larger incision to remove it.