Uterine fibroids are the most common pelvic tumors in women and are a significant cause of morbidity for women of reproductive age. Today, there are a variety of less invasive alternatives available to hysterectomy, such as myomectomy, hormonal therapy, uterine artery embolization, and more recently magnetic resonance-guided focused ultrasound surgery (MRgFUS). With this technique, ultrasound waves are focused through intact skin of the anterior abdominal wall resulting in localized thermal tissue ablation, monitored by online MR temperature control. By using an effective combination of image guidance and energy delivery, MRgFUS therefore allows for preservation of uterine function while obviating the need for a minimally invasive procedure or surgery.