Until the late 1990s, the primary reasons for obstetrician/gynecologists to involve interventional radiologists in the care of their patients were for pelvic/abdominal fluid collections and acute hemorrhage. Since 1995, an estimated 150,000 uterine fibroid embolizations (UFEs) have been performed. UFE improves fibroid-related bleeding and bulk symptoms, with low morbidity compared with hysterectomy. Patients requiring treatment who desire future fertility, especially those with distorted uterine cavities, are usually best served with myomectomy rather than UFE. Premyomectomy UFE for the massively enlarged uterus can decrease the risk of hemorrhage. UFE should be considered for, and discussed with, all appropriate candidates.