OBJECTIVES: UF is a chronic gynaecologic disorder that could be associated with substantial comorbidity burden. This systematic review examined the existing literature on comorbidities and symptoms among UF patients  METHODS: MEDLINE and EMBASE were queried for articles published in English between 2000 and 2013 using the following key words: “uterine fibroid/fibroids or leiomyoma/leiomyomas or leiomyomata” and “comorbidity/comorbidities, comorbid, risk factor, risk, multimorbidity, multimorbidities”. Studies where the population was limited to uterine fibroids patients with specific comorbidities were excluded. Review articles were reviewed to capture studies that did not appear in initial searches.  RESULTS: A total of 37 articles were reviewed. UF populations included women diagnosed with UF, symptomatic UF patients, UF patients that had been undergoing surgery, hospitalized patients with a UF diagnosis and pregnant women with UF whereas control populations included women with normal uterine morphology, women undergoing surgeries for benign conditions other than UF, pregnant women without UF or women with other conditions like adenomyosis or endometriosis. Most commonly reported gynecological conditions among UF patients were abdominal pain/discomfort (15.9%–24.2%), pelvic pain (11.2%–22.5%), painful intercourse (8%), menstrual cramps/painful menses (29%–37.3%) and pelvic pressure (2.2%–27%). Pregnancy-related complications were more frequent among UF patients compared to controls. UF patients also reported higher rates of non-gynecological conditions like anemia (1.26–22.97%), and constipation or gas (0.3%-2.71%) compared to controls but rates were not always significantly different Ethnicity also had a role in comorbidity burden. Two studies found that African-American patients had a higher rate of UF-related comorbidities than White women and were more likely to have higher rates of infertility, abdominal and pelvic pain, menorrhagia, fatigue and anemia. Most common UF symptoms reported were abnormal bleedings related to menstruation. CONCLUSIONS: UF is associated with significant symptomatic and comorbidity burden. Future population-based studies are needed to validate these findings