Uterine fibroids (also known as fibroids) are the most common solid tumors of the female pelvis and are the leading cause of hysterectomy. Although many women with fibroids are asymptomatic and can be followed up and monitored without treatment, some still require aggressive management. Because hysterectomy is the only treatment option that is definitively effective and reduces the recurrence of fibroids, it remains the most common form of treatment. Many patients who wish to preserve their reproductive function or who wish to preserve their uterus even after they have completed their reproductive function seek an alternative treatment to hysterectomy. As more and more alternative treatment options to hysterectomy become available, it is particularly important to address their efficacy and risks. The purpose of this guideline is to provide an overview of the pharmacologic and surgical treatment options available as alternatives to hysterectomy for the treatment of uterine fibroids and to provide treatment recommendations.