This investigation was conducted to evaluate the ability of uterine artery embolization to reduce the size of uterine fibroid tumors and to determine women's own assessment of the success of the procedure. Uterine embolization is a minimally invasive procedure involving insertion of a catheter into the uterine artery and embolization with polyvinyl alcohol particles (Boston Scientific Ltd, Cork, Ireland) 355 to 500 μm in diameter. Occlusion or reduction of flow in both uterine arteries is achieved with fiber platinum coils inserted into the artery (Boston Scientific Ltd). For this study, magnetic resonance imaging (MRI) scans were taken before and 6 months after embolization to assess the change in the uterine fibroid. T 2 weighted sequences on MRI were taken of all study subjects. T 1 weighted sequence scans were also taken of some patients but proved not to provide useful information. Study subjects were 114 unselected consecutive women who had undergone MRI 6 months after an embolization procedure. At 3, 6, 12, 18, and 24 months after the procedure, patients were asked to complete a questionnaire about their own assessment of the success of embolization. The 114 women were a mean of 42 years of age and had a total of 165 uterine fibroids, including 73 women with 1 to 3 fibroids, 14 with 4 to 10 fibroids, and 27 women with 11 or more fibroids. One hundred one of the tumors were less than 8.5 cm in diameter, and 64 were 8.5 cm or larger. After embolization, the total volume of the fibroids was reduced by a median of 58%. Ten women experienced complete destruction of their fibroids, and 5 had nearly total destruction (98% reduction in volume). The 64 women with large fibroids (>8.5 cm) had a median 50% reduction in tumor volume. There were three women whose fibroid tumors increased in volume after embolization. The women with interstitial (N = 38), submucous (N = 33), subserous (N = 30), or complex fibroid masses (N = 51) experienced a median reduction in tumor volume ranging from 63% to 52%. Pedunculated subserous fibroids (N = 7) had a median volume reduction of 38%, and pedunculated submucous tumors had a median 100% reduction. The results of the questionnaire showed that overall, 38% of the women had no further symptoms after uterine embolization, 53% reported an improvement in their symptoms, and 10% noticed no change or worsening of their symptoms. Women with smaller fibroid tumors were more likely and women with larger fibroids were less likely to experience a complete resolution of symptoms.