Since the 1950s, hysterectomy has been widely used clinically as a routine procedure for the surgical treatment of uterine fibroids. In the United States, 40% of the approximately 600,000 hysterectomies performed each year are due to fibroids; in China, where the population base is much larger than that of the United States, there are approximately 2.8 million total hysterectomies performed each year, more than half of which are due to fibroids. Removal of the uterus is equivalent to stopping the growth of fibroids at the source and eliminating the worry of future recurrence and malignancy, which is called “radical” treatment of fibroids. However, the loss of the uterus, a unique female organ, brings physiological and psychological trauma to the patient as well, especially in today’s world of higher quality of life requirements. In recent years, the role of the uterus for women is not only “to nurture the fetus and reproduce offspring”, but also: (1) the role of the uterus in maintaining the anatomical function of the female pelvic floor organs and preventing pelvic organ bulge. Clinical studies have shown that removal of the uterus, bulging of the posterior vaginal wall and excessive descent of the pelvic floor can cause defecation dysfunction in women; severance of the uterine ligaments and destruction of the parametrial tissues can result in impaired innervation of the bladder and rectum and may alter the overall structure and physiology of the pelvic floor. (2) Hysterectomy may cause a decrease in the blood supply to the ovaries, which in turn may affect ovarian function. (3) The uterus has an endocrine role. The endometrium secretes prostaglandins, prolactin, and a variety of substances such as insulin-like growth factor and epithelial growth factor; at the same time, the endometrium is rich in estrogen and progesterone receptors, which play a significant role in achieving endocrine regulation of the hypothalamus, pituitary, ovarian, and uterine systems. (4) The role of uterine nerve transmission in maintaining the female sexual reflex arc is of interest. (5) The psycho-spiritual impact of hysterectomy on women and the risk of surgical damage to the vesicoureter cannot be ignored. In view of this, the choice of hysterectomy for uterine fibroids should be weighed against the advantages and disadvantages of organ preservation and clear indications. The appropriate options for hysterectomy are: ① rapid growth of perimenopausal fibroids with suspected malignancy; ② continued growth of fibroids after menopause; ③ malignancy of fibroids; ④ multiple fibroids without fertility requirements, large size and related clinical symptoms, and cancer-phobic patients who require resection. Ultrasound focused non-invasive treatment of uterine fibroids is guided by medical imaging system, which focuses ultrasound beams outside the body to form a high-energy focus on the target fibroid tissue in the body, and thermally ablates and “removes” the fibroids, forming coagulative necrosis to achieve the treatment purpose. A two-center prospective clinical study reported a 91.7% improvement in symptom scores after ultrasound ablation of uterine fibroids, and a 59.0% average reduction in fibroids 6 months after the procedure, with no serious adverse effects. Ultrasound focused non-invasive treatment of uterine fibroids is an emerging non-invasive treatment that has gradually become more popular in gynecological clinical specialties. This new technology, compared with other clinical treatments in the past, has the characteristics of no incision, no bleeding, no pain, and no harm to normal tissues, and provides the treatment concept of early treatment, repeated treatment, and preferred treatment for the comprehensive treatment of uterine fibroids. There is still some controversy in the medical community about the treatment of uterine fibroids. The presence or absence of symptoms or the severity of symptoms in patients with uterine fibroids is the main basis for deciding whether treatment is needed. First of all, doctors do not recommend surgery for early stage patients with previous non-surgical indications, greater than or equal to 5 cm, with high estrogen and progesterone levels, and it is in a rapid growth process. Previously, it was controlled by medication, but medication control cannot cure it, it is only a palliative means. Now it can be treated by ultrasound focus for early intervention to reduce the harm of fibroids. Secondly, uterine fibroids are hormone-dependent conditions with a high recurrence rate without endocrine improvement, and there is a lack of effective clinical means for re-treatment, which generally requires total and subtotal hysterectomy. In addition, since focused ultrasound therapy is a non-invasive treatment, it can be performed first and then combined with other clinical means, thus reducing the riskiness of surgery. Besides uterine fibroids, there are some new indications for focused ultrasound technology in gynecological clinics including chronic pelvic pain, scar pregnancy, placenta implantation, ectopic pregnancy, uterine polyps, etc.