Myomas induce menorrhagia and pelvic pain, and increase the risk of infertility and obstetrical complications. Symptomatic sub-mucosal myomas are classically treated by hysteroscopic resection. Symptomatic interstitial and sub-serosal myomas may be treated by myomectomy, either by laparotomy or laparoscopy according to their number and size. Prophylactic myomectomy is not recommended to prevent from obstetrical complications or the risk of leiomyosarcoma. Although all myomas have a negative effect on fertility, the removal of sub-mucosal myomas is the sole recommendation to improve spontaneous fertility or assisted reproduction technology.