Background: Uterine fibroids are the most common tumor in women of reproductive age. By the time they are 50-years-old around 80% of women will have developed one. Of these, around half will experience symptoms which will impact negatively on their quality of life. Hysterectomy is the traditional treatment for women with symptomatic fibroids. For women who do not wish to undergo a hysterectomy, two invasive treatments are commonly available: myomectomy or uterine artery embolization (UAE). Aim and objectives: The present study has been done to compare quality of life after hysterectomy or myomectomy as treatment of fibroid. Methods: Women with symptomatic fibroids diagnosed by ultrasound were randomized to myomectomy or hysterectomy. Endpoints at 1 year were QoL measured by a validated questionnaire. Results: A statistically significant lower mean score was reported in the summary score (47.85±20.587 vs 53.35±27.548; P <0.001). The symptom severity score was higher among women planning hysterectomy compared with those planning myomectomy (62.85±26.547 vs 49.89±26.854), indicating worse symptoms among those scheduled for hysterectomy. Based on the EuroQoL 5-Dimension Health Questionnaire VAS, hysterectomy patients reported a lower quality of life compared with those planning to undergo myomectomy (68.26±21.424 vs 74.37±17.847; P<0.001, respectively). Conclusion: Hysterectomy and myomectomy substantially improved HRQOL at short-term follow-up (24 months), and there were small but statistically significant differences favoring hysterectomy in the Uterine Fibroid Symptom Quality of Life–specific subscales (concern, activity, and self-consciousness) and overall symptom severity