Background: Uterine leiomyomas are common benign tumors of the female reproductive system, but cervical fibroids are rare, accounting for 1–2% of all cases. This case report highlights a diagnostic challenge where a large exophytic intramural fibroid mimicked a cervical fibroid, termed as "pseudo cervical fibroid." Methods: A 50-year-old woman presented with a two-year history of white vaginal discharge without menstrual or pressure symptoms. Clinical examination revealed a suprapubic mass, assessed as a cervical fibroid. Investigations, including ultrasonography and MRI, identified multiple fibroids, with the largest (9×8×3 cm) located in the cervix. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed, and the specimen was analyzedhistopathologically. Results: Intraoperative findings included a bulky, vascular uterus with multiple fibroids and a large cervical fibroid, displaying the "lantern on dome of St. Paul’s cathedral" appearance. Histopathology revealed chronic cervicitis and confirmed the diagnosis of pseudo cervical fibroid. The surgical procedure was completed successfully without bladder or ureteric injury. Conclusion: Pseudo cervical fibroids pose a diagnostic and surgical challenge due to their atypical presentation and close proximity to vital pelvic structures. Comprehensive preoperative evaluation and surgical expertise are crucial for successful management. This case underscores the importance of distinguishing pseudo cervical fibroids from true cervical fibroids to guide treatment strategies effectively.