The study design was a retrospective case controlled study done to assess the safety and efficacy of myomectomy during caesarean section in Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh. The subjects were 46 pregnant women underwent elective or emergency myomectomy during caesarean section. All caesarean section myomectomy were performed by consultant gynaecologist and obstetrician. Intra-operative and post-operative complications such as length of operation, blood loss were estimated. Length of hospital stay was also recorded. Results: Myomectomy was performed at caesarean section after delivery of the baby and the placenta, with the administration of intervenes oxytocin. The fibroid defects were occluded with continuous interlocking and fixed sutures. Fibroids were on whole of the anterior uterine wall and upper part of the posterior uterine wall with most being subserous and intramural No hysterectomy needed at the time of caesarean section. There was no significant frequency of blood transfusion and incidence of post operative fever. The average duration of post operative hospital stay was 4 to 8 days. In selected cases myomectomy during caesarean section does not appear to be result in an increased risk of intrapartum or postpartum morbidity if performed by an experienced practitioner. Caesarean myomectomy may be a safe surgical option with no significant complications.