Fibroids are the most common female pelvic tumor; developing a fibroid or multiple fibroids by the time of menopause is the rule rather than the exception. The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) conducted a systematic review of the literature to update the evidence on the management of uterine fibroids. We systematically assessed the evidence on seven key questions (KQs): (1) incidence and prevalence of uterine fibroids, (2) outcomes of treatment for symptoms, (3) outcomes of treatment for reasons other than symptoms, (4) costs, (5) modifiers of treatment outcomes, (6) comparisons of treatments, and (7) geographic variation in treatment.