Background: Background: The effectiveness of uterine fibroid embolization in 1000 women with symptomatic leiomyomas. Uterine fibroid embolization (UFE) was introduced into practice in 1995. The aim of the study was to evaluate endovascular procedure efficacy in 1000 women with symptomatic leiomyomas. Material/Methods: 1000 women with symptomatic leiomyomas underwent UFE. In all patients, fibroids were confirmed with MRI and the symptoms included abnormal bleeding and compression of other organs. MR follow-up was performed in 964 women 3 months later, and in 853 women 12 months after UFE. Results: Technical success was achieved in 983/1000 cases. In 67 patients, the fibroid was supplied by the ovarian artery. In 3 women, massive spasm of the uterine artery was the reason for technical failure. 3 months after UFE, 877/ 964 (91%) were satisfied with endovascular treatment, 12 months later 699/ 853 (82%). 154 women were dissatisfied. 75 patients underwent at least one additional gynecological procedures 1-60 months after UFE. Dominant leiomyoma size reduction >30% was observed in all 964 patients 3 months after UFE. After 12 months, size reduction was >50% in 808/853 women. In 84/853 patients (11%), we found contrast enhancement within the fibroid but only 35 of them (4%) were symptomatic. Conclusions: Uterine fibroid embolization is an effective and safe method of symptomatic leiomyoma treatment.