Adenomyosis is a challenging clinical condition that is commonly being diagnosed in women of reproductive age. To date, many aspects of the disease have not been fully understood, making management increasingly difficult. Heavy menstrual bleeding and dysmenorrhea are the typical symptoms of adenomyosis, occurring in approximately 60 and 25 percent of women, respectively. The diagnosis of adenomyosis is based mainly on transvaginal ultrasonography and magnetic resonance imaging (MRI).A thickness of the junctional zone of at least 12 mm is the most frequent MRI criterion in establishing the presence of adenomyosis. Adenomyosis can appear as a diffuse or focal form. Although hysterectomy is a definitive treatment option, minimally invasive treatment methods have been developed as more women desire uterine preservation for future fertility or to avoid major surgery. Several uterine-sparing treatment options are now available, including medication, hysteroscopic resection or ablation, conservative surgical methods, high-intensity focused ultrasound, uterine artery embolization and radiofrequency ablation each with its own risks and benefits.