Background and Aims: Adenomyosis has low clinical outcomes and is common among older patients. There are three types of treatment, drug administration and surgery to eliminate or alleviate symptoms, and assisted reproductive technology (ART) to achieve pregnancy. However, there are no uniform selection criteria or priorities. We report the clinical outcome of treatments of uterine adenomyosis in 360 cycles following ART over 12 years and propose future treatment of the condition. Method: We retrospectively analyzed the clinical pregnancy, live birth, and miscarriage rates of 126 patients with uterine adenomyosis (Ut-Ad) who received ART at our hospital and compared them with non-Ut-Ad individuals as controls. Results: There were no significant differences in the fertilization rate [70.3%(1316/1872), 69.8%(15570/22309)], cleavage rate [68.9%(1289/1872), 68.5%(15274/22309)] and blastocyst formation rate [42.6%(560/1316), 43.0%(6693/15570)] between the two groups. Ut-Ad group showed significantly lower clinical pregnancy rate, live birth rate and higher miscarriage rate than. Conclusion: The main factors of lower clinical outcome of ART of Ut-Ad were not clear. Kinetic alteration of uterine wall seems to be caused by ectopic endometrial tissues invasion.