Background: Uterine fibroid is the most common benign pelvic tumor in women. Pyomyoma is a rare complication of uterine fibroid and potentially fatal if not treated with antibiotics and surgical intervention. Case Report: Initially the patient presented with heavy vaginal bleeding and fever, temperature of 38℃, pulse of 125 per minute. Ultrasound (US) revealed a large intramural fibroid measuring (11.8×11.2 cm). A CT revealed gas within the fibroid and pyomyoma was the most likely diagnosis. The patient was successfully treated with antibiotics and myomectomy. Microbiology results demonstrate clostridium ramosum as the causative organism conforming rare diagnosis of pyomyoma. Conclusion: Pyomyoma is rare but potentially fatal condition if not treated. It is usually associated with super-added infection. The most prominent symptom of the condition is fever with no obvious origin. Fever which is not responding to antibiotic is also an evident feature of pyomyoma. Although rare, it must be a differential diagnosis in postpartum women who present with pyrexia of unknown origin.