Torsion of a uterine leiomyoma is an extremely rare, albeit life-threatening surgical emergency. A 28-year-old woman presented with acute abdominal pain. Imaging revealed a torsed subserosal uterine leiomyoma which was managed surgically and the diagnosis confirmed intraoperatively as well as on histopathology.ContributionWhile intraoperative findings remain the primary means of diagnosis, radiologists should be familiar with the potential imaging findings of leiomyoma torsion as timely intervention can greatly improve patient outcome.