Myomectomy is the most commonly performed procedure for women with large fibroids who want to preserve their uterus. Since myomectomy is associated with a 15-30% rate of fibroid recurrence, a systematic assessment of long-term resource use is critical for evaluation but to date no comprehensive analysis have been performed. OBJECTIVE: To evaluate the long-term outcomes and cost of myomectomy through retrospective claims data analysis. METHODS: The study was performed using the MEDSTAT MarketScan private pay fee-for-service database for the years 1995, 1996, and 1997. Patients were selected for analysis based on the presence of ICD-9-CM procedure and/or CPT-4 codes associated with myomectomy. In addition, diagnosis of uterine fibroids and related symptoms for these patients were confirmed through ICD-9-CM diagnosis codes. Inpatient, outpatient, physician, and pharmacy data for all three years were combined into a single file using unique patient identifiers. All cost data were converted to 1997 dollars. RESULTS: A total of 3,730 women, between the ages of 19 and 62, were available for analysis. Of these, 39% had an inpatient admission while the remaining only had outpatient procedures. The estimated cost of an abdominal myomectomy procedure was $7,551 and that of a vaginal myomectomy was $3,136. Preliminary analysis indicates that at least 8% of the women had an additional procedure within a year and a higher percentage in subsequent years. There were also a high number of fibroid-related outpatient visits and some prescription medication use. CONCLUSION: The high number of repeat procedures, outpatient visits, and prescription medication add significantly to total cost and highlight the importance of assessing overall healthcare utilization. This comprehensive analysis facilitates the systematic evaluation of myomectomy with emerging alternative treatments for uterine fibroids.