This video demonstrates the laparoscopic myomectomy of a giant posterior intramural-transmural (Type 2–5) fibroid in a woman with menorrhagia. The procedure begins with diagnostic hysteroscopy, confirming that the uterine cavity is normal apart from compression caused by the fibroid. During laparoscopy, the surgeon discusses techniques to reduce blood loss, including vasopressin injection and the option of temporary unilateral uterine artery ligation. The fibroid is carefully enucleated followed by meticulous multilayer uterine reconstruction using advanced laparoscopic suturing techniques. The operation concludes with specimen retrieval, confirmation of hemostasis, and secure port closure, making this an excellent teaching case for complex fertility-preserving myomectomy.