Uterine leiomyoma, commonly known as uterine fibroids, are benign smooth muscle tumors of the uterus that are sensitive to estrogen. They are quite common, affecting 20-30% of reproductive-aged women. Risk factors include being African American, nonsmoking, obesity, and perimenopausal age. While often asymptomatic, fibroids can cause symptoms like bleeding, pain, infertility, and pregnancy complications. Treatment options depend on symptoms and include expectant management, medical therapies, myomectomy, uterine artery embolization, hysterectomy, and potentially future gene therapies.