Postmenopausal uterine fibroids with punctate blood flow signal, there is the possibility of malignant transformation, but it is not absolute. Postmenopausal uterine fibroids with punctate blood flow signals indicate the presence of blood flow in the uterine fibroids, suggesting that uterine fibroids grow faster, but there is also the possibility of malignant changes. Uterine fibroids are generally mostly benign lesions, and the possibility of malignancy is relatively small. After menopause, when hormone levels drop, fibroids may shrink or disappear. The presence of blood flow in fibroids after menopause mostly indicates that there is a blood supply to the fibroids and that the fibroids may grow at a faster rate. If the examination is carried out with degeneration and calcification of the sarcoma in addition to punctate blood flow signal, it indicates that the possibility of malignant transformation is higher. Therefore, when a punctate blood flow signal is detected in postmenopausal fibroids, dynamic monitoring of the size, nature and shape of the fibroids is recommended. If malignancy is suspected, early surgical treatment is recommended.