The typical problems presented by uterine leiomyomas have traditionally been evaluated by pelvic and abdominal examinations. Cantuaria and coworkers reported a strong correlation between bimanual examination and ultrasound examination with regard to determining the size of uterine myomas. 10 The addition of ultrasonography (Fig. 3) and especially of magnetic resonance imaging (MRI) (Fig. 4) has increased the accuracy in the diagnosis and measurement of uterine leiomyomas. MRI often can differentiate adenomyosis from the leiomyoma. Radiologic studies are particularly important when the physical assessment is difficult, as in the case of morbid obesity, or when adnexal pathology cannot be excluded on physical examination. If there is any uncertainty about the diagnosis of uterine leiomyomas after radiologic studies, laparoscopy (Fig. 5), or laparotomy should be performed.