There are many reasons for an enlarged uterus, which need to be diagnosed and treated accordingly. If the uterus is normally enlarged physiologically, i.e. pregnancy uterus, the uterus will slowly contract and return to its original size after the woman has given birth. No treatment is needed. If the uterus is enlarged for other reasons, treatment will be needed depending on the cause. If the uterus is enlarged due to fibroids, it depends on the location of the fibroids and the number and size of the fibroids to decide whether to observe or treat them with medication or surgery. Uterine hypertrophy is a disease in which the uterus is uniformly enlarged and the thickness of the myometrium exceeds 2.5cm or more, accompanied by uterine bleeding of varying degrees. The treatment starts with conservative treatment with medication, and if the conservative treatment is ineffective, surgical treatment is needed. Functional uterine bleeding caused by uterine enlargement, the general principle of treatment is that the bleeding stage should be quickly and effectively stop bleeding, and after the bleeding stops, suitable programs should be selected to prevent recurrence. Surgery can be used for patients who have poor drug efficacy or who are not suitable for medication or who have no requirement for childbearing. Clinical adenomyosis needs to be individualized according to the patient’s age, symptoms and fertility requirements. Surgery and drug treatment options can be chosen simultaneously. In conclusion, in addition to physiological reasons, the enlarged uterus still needs to be treated symptomatically.