목적: To evaluate the clinical value of the ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation on uterine fibroids and adenomyosis. 방법: A total 12 patients with solitary uterine fibroid(n=6) or adenomyosis(n=6) at a single center were treated with USgHIFU. Symptom Severity Score(SSS) was evaluated and recorded before HIFU treatment, and 3-6 months after the treatment. Contrast enhanced MRI was performed before HIFU treatment, and after 3-6 months after the treatment. Any complications after the treatment were investigated and recorded at follow up in every patient in this study. 결과: The average follow up duration of SSS and contrast enhanced MRI was 4.29 months. The average score of SSS before HIFU treatment was 62.3(range 51-92). The average score of SSS after HIFU treatment was 29.1(range 0-61). The median volume of uterine fibroids was 420.30cm3 (range 106.00-920.76cm3) before HIFU treatment. The median uterine volume of adenomyosis was 254.50cm3 (range 109.28-677.95) before HIFU treatment. The average reduction rate of uterine fibroid was 44.57%. The average reduction rate of adenomyosis was 46.37%. No major complication was found after the HIFU treatment. The most severe complication case was prolonged vaginal bleeding and vaginal discharge. The most common complication was abdominal discomfort which was subsided naturally in 1-14 days after the treatment. 결론: Based on our results, USgHIFU ablation of uterine fibroids and adenomyosis appears efficient and safe; however, large scale studies are required to confirm these data.