Pelvic US, magnetic resonance imaging (MRI), and computed tomography (CT) imaging are more common modalities in assessment of the uterus and the cervix. Pelvic US is the most common initial imaging approach in diagnosis of uterine disease. Modalities for pelvic US include a transvaginal approach, transabdominal approach, and saline infusion sonohysterosalpingogram. Pelvic US plays a significant role in the diagnosis of uterine leiomyomas (submucosal, intramural, and subserosal) and polyps and in the monitoring of follicular development in assisted reproduction. In more recent years, 3-dimensional (3D) US has been investigated in comparison to 2-dimensional (2D) US and hysteroscopy. Salim and colleagues showed 3D US to be superior over 2D US in the measurement of intramural versus submucosal involvement of leiomyoma. Additionally, US is often the initial test to suggest other pathology such as müllerian anomalies and adenomyosis. Occasionally, the detection and localization of myomas, assessment of their size, and their differential diagnosis are difficult. In the circumstances of adenomyosis, müllerian anomalies, or additional information needed on myomas, it can be useful to perform MRI of the pelvis. MRI produces images with excellent soft tissue resolution and is useful for evaluation of congenital abnormalities of the uterus, leiomyomas, adenomyosis, gestational trophoblastic disease, and endometrial carcinoma diagnosis and staging. MRI can accurately measure the volume of the myoma, which aids in determining whether medical management of myomas has resulted in shrinkage or whether conservatively treated myomas are growing. Malignant degeneration of myomas visualized by MRI, as described by some authors, allows for early and appropriate intervention.