A case report patient with pyometra is infrequent. The aim of this communication is to present rare manifestations of it. A 65-year-old female with an ovarian cyst diagnosis was evaluated. She reported that since two years ago abdominal perimeter increased progressively. Physical exam revealed a 28 cm abdominal tumor. An ultrasound and a CT scan supported clinical diagnosis.white cell count 7100/mm3, and CA-125: 214 U/mL. With a presumptive ovarian cancer diagnosis an exploratory laparotomy was carried out.a 26 cm uterus with atrophic ovaries. A total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The histopathology test results revealed a massive coagulated pyometra.A giant pyometra is an exceptional event, and also it can increase CA-125 serum levels.