Uterine fibroids or leiomyomas are considered one of the most prevalent benign tumours in women of reproductive age. The aim of the present study is to evaluate myomectomy, as compared with UAE, in women who had symptomatic uterine fibroids and did not want to undergo hysterectomy regarding recurrence of symptoms (pain and bleeding) and recurrence of tumours. Methods: We performed a prospective randomized clinical trial on 100 symptomatic uterine fibroids. Patients were eligible if they have at least one symptom caused by uterine fibroids, such as menorrhagia, pain, or bulk-related symptoms that can be treated with myomectomy or uterine-artery embolization. Patients were randomly divided equally in two groups Group A(n=50): underwent Uterine Artery Embolization(UAE), Group B(n=50): underwent myomectomy Results: Patients' satisfaction was significantly higher in group A compared to group B (86% vs. 64%, P=0.020), improvement of symptoms was significantly better in group A compared to group B (82% vs. 52%, P=0.003) and reduction in fibroids after 1 year was higher in group A than group B with no statistically significant difference between both groups. Regarding the recurrence of symptoms, group A showed significant improvement in postoperative bleeding and VAS at 1, 3 and 6 months compared to group B (P<0.05) whereas postoperative bleeding and VAS were comparable at 1-year between both groups. Conclusion: UAE may be more effective in controlling patients’ bleeding, pain, has lower rates of post-procedural blood transfusions, postoperative complications and higher rates of patients' satisfaction and symptoms improvement