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Objective: This case report evaluates a 51-month follow-up of the hormonal profiles and the menopausal status after fresh autologous hemi-ovary transplantation to the Pfannenstiel incision site in a woman aged 32 years after a total hysterectomy and accidental bilateral salpingo-oophorectomy. Case Report: A 32-year-old, unmarried woman without sexual experience had undergone a total hysterectomy and accidental bilateral salpingo-oophorectomy for huge uterine fibroids and dense pelvic adhesion. A fresh autologous right normal hemi-ovary was transplanted into the adipose tissue on the right side of the Pfannenstiel incision site. During the 51-month follow-up after transplantation, a series of hormonal profiles for serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2) and progesterone were carried out, together with ultrasound detection of the presence of subcutaneous follicles and an analysis of menopausal symptoms. Postoperative hormone levels at months 14, 18, 22, 30 and 51 were as follows: (1) FSH, 17.06, 11.33, 51.44, 28.6 and 61.41 mIU/mL, respectively; (2) LH, 15.1, 6.7, 20.1, 15.7 and 28.9 mIU/mL, respectively; (3) E2, 79.7, 128, 55.9, 18.6 and < 10pg/mL, respectively; and (4) progesterone, 4.52, 9.51, 0.67, 0.45 and 0.25ng/mL, respectively. The hormonal levels after month 22 indicated a menopausal status. Ultrasound evidence of follicles was present until 30 months after transplantation. Conclusion: This case study showed a subcutaneous fresh autologous hemi-ovary transplant survived for at least 18 months after transplantation.