This video demonstrates laparoscopic myomectomy for posterior wall fibroid uterus with endometriosis. Laparoscopic myomectomy is only appropriate when indi- cations for surgery have been met. Pelvic pain, pressure, and abnormal uterine bleeding are the most common symptoms that lead women to seek surgery for fibroids. This patient has fibroid uterus which is adhered with Rectum. She has mild endometriosis of cul de sac as well. Up to 50% of uterine fibroids cause symptoms severe enough to warrant therapy. In this patient for endometriosis electrosurgical fulgration is done and Interceed is also used. The surgical therapy, depending on the type of myoma, may consist of myomectomy and hysterectomy (by abdominal, laparoscopic, or vaginal route), myolysis, or hysteroscopic resection.