A uterine fibroid is a benign smooth muscle neoplasm of the uterus. Parasitic fibroids (PMs) are a type of myoma that do not have any direct attachment to the uterus. PMs can arise from the implantation of tissue fragments generated during the morcellation process in previous laparoscopic myomectomies or hysterectomies. Transvaginal ultrasound (TV-US) may be helpful in the diagnosis of these benign tumors. Almost all the case reports in the literature suggest surgical management of parasitic fibroids. Conversely, we report an ultrasound-guided histological diagnosis and a non-surgical treatment of a parasitic myoma that arose twenty years after a total laparotomic hysterectomy and bilateral adnexectomy in a patient with multiple comorbidities, in order to offer a follow-up alternative to the management of this rare pathology. Our experience reveals that a non-surgical conservative approach can be considered as an alternative therapeutic option for the management of rare cases such as PMs in highly selected patients.