The article addresses the treatment of uterine fibroids, which is still relevant. According to numerous studies, about 70% of females under 50 have uterine fibroids, the most common condition among perimenopausal women. The prevalence of giant forms is not high and accounts for less than 5% of all cases, especially at early diagnosis. The surgical strategy in such cases is individual and depends on many factors: size, location of nodes, and women's reproduction plans. In these clinical cases, the management of patients with giant uterine fibroids is presented according to the multimodal principles of fast-track surgery in a modern gynecological hospital. We described the main approaches in diagnosis, preoperative preparation, surgery features, and subsequent recovery to reduce the complication rate, the duration of inpatient treatment, and postoperative rehabilitation in the treatment of giant uterine fibroids.