Abstract: Objective : To investigate the influencing factors of therapeutic efficacy of high intensity focused ultra-sound (HIFU) treatment for uterine fibroids through analyzing the sonogram. Methods : A total of 28 patientswith uterine fibroids (32 uterine fibroids in total) were treated with HIFU. We evaluated the correlations of dif-ferent volume, type, echo intensity, echo homogeneity with the therapeutic efficacy. The uterine fibroids weredivided into 3 groups according to each factor: 3 groups by size: <4cm³, 4~65cm³ and >65cm³; 3 groups bytypes: subserous myoma, intramural myoma and submucous myoma; 3 groups by echo intensity: hyper echo,iso-echo and hypo echo; 3 groups by echo homogeneity: heterogeneity, lack of uniformity and uniformity. At 6months after HIFU treatment, the results were assessed by ultrasound examination and clinical symptomchanges. The treatment outcomes were of four classes: curative, excellent, effective and ineffective. Results :With different volume, type, echo intensity and echo homogeneity, the therapeutic efficacy of HIFU treatmentwas different (P<0.05). For uterine fibroids of different size, therapeutic efficacy was best in the 4~65cm³ group, worst in the <4cm³ group and intermediate in the >65cm³ group. For different types of uterine fibroids,the therapeutic efficacy was best in the intramural myoma group, poorest in the subserous myoma group, andintermediate in the submucous myoma group. For the different echo intensity of uterine fibroids: the hyper-e-cho group had the best therapeutic efficacy, the hypo-echo group had the poorest therapeutic efficacy, andthe iso-echo group had the intermediate therapeutic efficacy. For the different echo homogeneity of uterine fi-broids, the efficacy of HIFU was best in the heterogeneity group, poorest in the uniformity group, and interme-diate in the group in lack of echo uniformity. Conclusion : Analysis of the correlation between the sound imageof uterine fibroids and the efficacy of HIFU is helpful for evaluating the accuracy of ultrasound in measuringthe effect of HIFU.