Background: The main aim of treatment of symptomatic fibroids by various modalities including uterine fibroid embolisation is to alleviate symptoms and ultimately improve the quality of life. The efficacy of this modality of treatment in women with significant fibroid burden and large uterine volumes is not clear. Objective: To determine the change in symptom severity and health-related quality of life among patients who have undergone uterine fibroid embolisation for treatment of symptomatic uterine fibroids. Setting: Aga Khan University Hospital, Nairobi Methods: A prospective before and after study (observational) of patients undergoing uterine fibroid embolisation. Prior to embolisation, study participants underwent a pelvic MRI and filled in the Uterine Fibroid Symptom and Quality of Life questionnaire (UFS-QoL), a disease-specific symptom and health-related quality of life questionnaire for fibroids. The same questionnaire was administered after one year. Outcome measures: The main outcome was change in symptom severity score. Secondary outcome measures were change in health-related quality of life (HRQoL) score, the correlation between age, parity, uterine volume, fibroid number and change in the symptom severity and health-related quality of life scores and the incidence of an additional intervention. Results: Data from 80 study participants were included in the analysis. The mean change (improvement) in the symptom severity score was -29.6(SD±27.1) [95% CI -35.6 to -23.6, P<0.001] with a mean change (improvement) in health-related quality of life score of 35.7(SD±32.7) [95% CI 28.4 to 42.9, P<0.001].There was a significant positive correlation between fibroid number and change in symptom severity score. There was no significant correlation between age, parity, uterine volume and change in symptom severity score. There was a significant positive correlation between parity and change in the health-related quality of life score. There was no significant correlation between age, uterine volume, fibroid number and change in the health-related quality of life score. The incidence of a major and minor surgical intervention during the one year follow-up period was 6.25% and 12.5% respectively.iv Conclusions: UFE is associated with a statistically significant and clinically useful improvement in symptom severity and health-related quality of life in women with symptomatic fibroid disease and is an effective treatment option of symptomatic fibroids in patients with large myoma burden or large uterine volumes.