Uterine fibroids are the most common benign tumors of the female reproductive tract. The reassuring aspect of fibroids is that they are essentially benign and have a low probability of malignancy (about 0.47%), which is the main reason why doctors dare to take observation of patients with asymptomatic fibroids. In fact, many women have undiagnosed fibroids that coexist with the tumor without affecting their health. For small fibroids (e.g. 2-3 cm in diameter, or smaller, found by ultrasound during physical examination) without symptoms such as excessive menstruation, pain, difficulty in urination, or anemia, observation is generally recommended, with ultrasound or pelvic examination performed every 3-6 months. Women do not have to panic about such small fibroids, they can just think of it as a wart on their face. However, treatment should be considered in the following cases: 1. if a single fibroid exceeds 5 cm in diameter, or if the total uterine volume exceeds the size of the pregnant uterus for 2-3 months. 2. If the fibroids are small but cause symptoms due to their location, such as fibroids in the lower part of the uterus and the cervix (cervical fibroids), which cause frequent urination, urgency or difficulty in urination; fibroids pressing on the rectum, which cause constipation or diarrhea; fibroids in the uterine cavity (submucosal fibroids), which cause excessive menstruation and even anemia. 3.Multiple miscarriages or infertility, and fibroids are suspected as the main cause. 4.There are signs suggesting fibroids malignancy: pre-existing fibroids increase in size instead of shrinking after menopause; sudden and rapid increase in size of fibroids in the near future; ultrasonography suggests that fibroids are extremely rich in blood flow, etc. The treatment plan should be determined according to the patient’s age, fertility requirements, and the size of the fibroids, including: (1) Scraping: If the fibroids are combined with irregular menstruation, diagnostic scraping should be performed to exclude the endometrial lesions and to temporarily treat the bleeding caused by the fibroids. (2) Myomectomy: The tumor is removed from the uterus and the uterus is preserved. This procedure is suitable for young women who need to preserve their reproductive function; submucosal fibroids located in the uterine cavity can be removed vaginally if they have prolapsed outside the cervical opening. There is a possibility of recurrence after myomectomy and, as will be discussed later, there are some special notes for women who need to be pregnant. (3) Total or partial hysterectomy: It is the most traditional method of treating fibroids, which means that the uterus is removed along with the fibroids. Due to changing medical concepts and the importance women place on themselves, it is becoming more and more prudent to treat fibroids by hysterectomy, as will be discussed in detail in the next section. (4) Uterine artery embolization: With the help of angiographic techniques, a special catheter is inserted through the femoral artery, and under the guidance of angiography, the catheter is selectively placed into the bilateral uterine arteries and the vessels are blocked with special drugs or devices in order to block the blood supply to the fibroids, thus causing necrosis or shrinkage of the fibroids. (5) High-intensity focused ultrasound (HIFU): HIFU is to accurately focus low-energy ultrasound from outside the body on target tissues by focusing ultrasound, so that the energy can be amplified thousands of times, resulting in instant high temperature (65℃~100℃) and cavitation effect, causing coagulative necrosis of the tumor and cavitation effect causing rupture of cell membrane and nuclear membrane and loss of diffusion ability, thus achieving the purpose of destroying the lesion. (6) Sex hormone therapy: For patients with large or specially located fibroids (such as cervical fibroids and broad ligament fibroids) or anemia, gonadotropin-releasing hormone agonist (GnRHa) therapy can be used to lower estrogen levels, shrink fibroids and reduce menorrhagia, so as to improve patients’ anemia and reduce the difficulty of surgery. With such a wide variety of approaches, there is no best, but what is appropriate is good. It is up to the physician to consider all the options, explain the pros and cons and give preferential advice, and finally let the patient make the decision.