Ovarian fibroma is a mesenchymal cell tumor of the sex cord and is the most common solid tumor of the ovary, accounting for 1-4% of all benign ovarian tumors. The most common symptoms are abdominal discomfort and pain, but most patients do not present with specific symptoms. These solid tumors are often difficult to diagnose by preoperative ultrasonography and are often misdiagnosed as uterine fibroids. They are also often misdiagnosed as ovarian malignancies because of the accompanying ascites and elevated CA-125 levels. Ovarian fibroids cause the vast majority of benign tumors, and Magee syndrome is a very rare but well known syndrome. It is defined as a benign solid ovarian tumor with pleural and/or ascites fluid. Most ovarian fibroids can be cured surgically. However, the optimal treatment for ovarian fibroids has not been adequately studied. Surgeons can barely remove the tumor laparoscopically, but safely moving the isolated tumor out of the abdominal cavity is quite difficult. However, recent advances in surgical instruments and techniques have led to the increasing popularity of laparoscopic surgery in gynecologic surgery. Macciò et al. reported such a case and published their findings in a recent issue of BMC Surg. The patient had a giant ovarian fibroid accompanied by Magee’s syndrome with clinical manifestations of abdominal pain and severe hemolytic anemia and was given laparoscopic treatment. The patient had severe clinical symptoms and was considered to have a distorted giant ovarian mass with Magee’s syndrome and possible hemolytic anemia, so we first focused on effective medical treatment and chose the most appropriate surgical treatment after laparoscopy. The main aim of the above treatment strategy is the management of preoperative anemia. Blood transfusions and glucocorticoid therapy ensure stable hemoglobin levels and normal bilirubin levels. A laparoscopic procedure was performed 4 days after the diagnosis of the tumor to remove the large ovarian fibroid, which quickly resolved the symptoms and was discharged after a short hospital stay. This case highlights the difficulties that can be encountered in the management of patients with Magee syndrome, including the possibility of misdiagnosis of malignant ovarian tumors, which may affect subsequent medical and surgical treatment, the adverse effects of Magee syndrome on the patient, especially acute pain and severe anemia. This case demonstrates the feasibility and safety of laparoscopic surgery for potentially large malignancies, but requires an experienced gynecologic oncology team that goes beyond the expertise of a general surgeon. Diagnostic laparoscopy is useful in patients with potential malignancy and laparoscopic lumpectomy can be performed if there are signs of malignancy.