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Occult metastasis in uterine subserosal leiomyoma from squamous cell carcinoma (SCC) of uterine cervix is rarely reported. A 50-year-old woman presented to the emergency department with acute abdominal symptoms. Computed tomography (CT) scan showed an over 20 cm pelvic tumor. The patient underwent a surgical excision of the tumor which was found to be a pedunculated subserosal leiomyoma of uterus. However, histopathological examination showed a leiomyoma with metastatic SCC confirmed by immunohistochemistry.