Fibroids are very common condition, accruing in the majority of women over 40 years. Fibroids may cause problems with menstrual periods and, if large, pressure symptoms causing abdominal bloating and bladder problems and sometimes pain. Not all fibroids need removing. To avoid unnecessary intervention we provide a modern, evidenced based approach to the investigation and management of this very common condition. Where appropriate we try and use telescopic techniques for their removal.