If the uterine fibroid is 5.1×4.9 cm at the age of forty-five and the clinical symptoms are not obvious, it can be treated conservatively without surgery first; if the clinical symptoms are obvious or accompanied by the possibility of fibroid degeneration, surgery can be considered. 1. Conservative treatment: if the symptoms are not obvious, it is recommended to have regular checkups, and generally can not operate first. Uterine fibroids are common benign proliferative diseases in women of reproductive age, generally the tumor is under 5 cm, and the clinical symptoms are not obvious, most of them can be treated conservatively, and regular checkups can be done to find out whether there is any growth of uterine fibroids. 2. Surgery: if the fibroid is 5.1×4.9 cm at the age of forty-five, accompanied by heavy menstruation or even anemia; the fibroid grows rapidly, and malignancy cannot be ruled out; the imaging examination finds that there is a possibility of degeneration of the fibroid; conservative treatment with medicines fails to control the growth of the fibroid; there is no atrophy of the fibroid after the menopause, or it continues to grow; and the subplasmacytomas are with obvious symptoms of compression of the bladder or rectum, then surgery can be considered in most of the cases. Surgery can be considered. Forty-five-year-old uterine fibroids 5.1 × 4.9 cm, it is recommended to go to the gynecology department of the local hospital in a timely manner, a comprehensive assessment to see, according to their own situation to formulate a treatment plan, to avoid leading to degeneration of the fibroids, anemia, or the emergence of symptoms of compression and so on.