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Uterine leiomyomatas (ULs) affect up to 80% of women during their reproductive years. Though relatively benign, they can have life-threatening complications. This case report presents a 50-year-old, postmenopausal female who presented with severe abdominal pain secondary to massive hemoperitoneum. Upon exploratory laparotomy, a large, pulsing artery was seen on the uterus, consistent with a ruptured subserosal uterine fibroid. This case offers unique insight into the presentation and management of this surgical emergency.