Despite the available effective screening techniques, cervical cancer is the most common genital malignancy in Romania. In patients with isolated pelvic recurrence after radiotherapy, exenteration represents the only chance for curative treatment. We present the case of a 45-year-old patient with a massive pelvic tumour causing intensive, poorly controlled vaginal bleeding, bilateral hydronephrosis and chronic renal failure. She underwent total infralevatorian exenteration with vulvectomy. Postoperative recovery was uneventful, and she presented a good evolution in the two months following surgery. We consider pelvic exenteration as the last treatment option to cure irradiated pelvic tumour recurrences.