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WATCH: Venus Williams outlasted Camila Giorgi in the first round of the Rothesay Classic.

Venus Williams might've slipped and fallen on court on Monday at the Rothesay Classic in Birmingham, but by the end of more than three hours of play, she was standing tall. The 43-year-old American overcame both an injury scare, and Italy's Camila Giorgi, in the opening round of the WTA 250 event for her third win of any kind in the last three years.

Ranked just inside the world's Top 700 at No. 697, Williams showed flashed of her vintage best to upset the 48th-ranked Giorgi 7-6(5), 4-6, 7-6(6), in three hours and 17 minutes. It was the 42nd WTA main-draw match this year to last three hours or more, and improved Williams' head-to-head record against Giorgi to 3-0. They hadn't played in five years.

But there were concerns that Williams wouldn't last much longer than the match's first five games: After breaking the Italian's serve twice to start the match, the American was snakebitten by a knee injury in the fourth game, and needed medical treatment at the changeover. She also took a hard fall in the opener, landing on her back.

But, by the end of the final set, Williams' steely nerve, and the fighting spirit that's defined her three-decade career, saw her through to her first win over a Top 50 player since 2019.

"I thought I played so well today, and she also played incredible," Williams said afterwards. "I'm so surprised she's not No. 1 in the world. There were so many moments where I just thought, 'This match is over,' and she would hit a shot from out of nowhere.

"She pushed me to be better than what I thought I could be, and it's great for me. I haven't played a lot of matches, and it's great to come through."

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Williams has been sidelined since January due to a hamstring injury before returning last week at another WTA 250 in the Netherlands. There, she led 17-year-old Swiss Celine Naef by a set and a break before falling in three sets, and she nearly let another lead slip away. She led 5-3 in the decider, served for the match at 5-4, and had a match point earlier in the tiebreak.

Williams ultimately won the match despite breaking Giorgi's serve fewer times than she was broken (four to five), and winning fewer overall points (121 to 122).

"I haven't played her in so long, and every set has been just like today," Williams said. "She loves this surface and she's dangerous out here. I hit some serves at 120 [m.p.h.] today, and I haven't done that in a couple of years. I was like, 'Oh my God, there it is! I missed you.'

"I got to a great start, and my leg started hurting in the third game. I was like, 'Oh no, not this.' It was really hard to control my emotions, to be honest, but eventually, I just acclimated to what I was going through. I couldn't move as well as I wanted, but I tried to get to every ball that I could."

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Williams is making just her second-ever appearance in Birmingham, and is in the field this week as a wild-card entry. She previously played the tournament in 2019, also as a wild card, and reached the quarterfinals. This year marks just the seventh time in her 20-plus years on tour that the five-time Wimbledon champion has played a grass-court tournament that isn't held at the All England Club.

"It's nice to see everybody here again," Williams said. "I haven't been here in a few years and not because I didn't want to be. I just really wasn't on tour. I'm just so happy to be back."

In other Monday action, Czech teenager Linda Fruhvirtova overwhelmed Elina Svitolina 6-2, 6-0 in the latter's first match since a resurgent run to the Roland Garros quarterfinals. Third seed Magda Linette of Poland came from a set down in her opening win over Italy's Jasmine Paolini, while Svitolina's countrywoman Anhelina Kalinina, seeded No. 5, knocked out American Alycia Parks in straight sets.