Aim: To evaluate the recurrence rate of uterine fibroids (UF) after abdominal myomectomy and the risk factors for recurrences. Methods: In a retrospective study, transvaginal ultrasound examinations were performed in 135 women after abdominal myomectomy. The main outcome measures were cumulative UF recurrence rates after abdominal myomectomy. The Kaplan-Meier survival analysis was used to estimate the cumulative recurrence rate, and log-rank tests were applied to compare survival curves among different categorical groups of potential risk factors for recurrences. Results: The cumulative UF recurrence rates at 12 and 24 months after abdominal myomectomy were 12.4 and 46.0%, respectively. Women who had a history of previous myomectomy had a higher hazard of UF recurrence than women without such a history (hazard ratio 4.1, 95% confidence interval 1.20-13.6). The women having four or more UFs had a higher hazard than those who had less than four UFs (hazard ratio 3.7, confidence interval 1.41-9.88). After adjusting these variables to each other, the hazard ratio remained similar. Conclusions: The UF recurrence rate detected by transvaginal ultrasound after abdominal myomectomy was high, but did not require any additional surgery. Physicians need to consider the timing of the myomectomy, taking into account complications of pregnancy and infertility due to UF recurrence. Copyright © 2006 S. Karger AG.