Uterine myomas or fibroids represent the most common pathology in female genital tract. There are marked differences by race in both prevalence and incidence. Pathogenesis of fibroids is still unclear. Several risk factors have been identified, ranging from genetic predisposition to variable lifestyles, with recurrence in positive family history for fibroids. Although most of them are asymptomatic, they may cause abnormal uterine bleeding and pelvic pain, and are associated with several pregnancy-related complications, spontaneous abortion, preterm delivery, and cesarean delivery. Moreover, fibroids are associated with several adverse reproductive outcomes and in 10% of infertility case. These fibroids related problems can negatively impact daily living and quality of life. Frequently, the diagnosis is incidental and the treatment is based on symptoms and patient’ wishes, depending on age, numbers and fibroid’ size, woman's fertility plans and risk of malignancy. Because of the high estimated prevalence and costs associated with treatments, the direct and indirect costs of uterine fibroids are substantial. This manuscript reviews the current literature on uterine fibroids, focusing on updated researches on fibroid management in asymptomatic women. Unfortunately, from the data examined, there is no univocity of diagnosis and treatment, thus, further large studies are need to define the management of asymptomatic fibroids