A retrospective study to determine the incidence, clinical presentation and management of uterine fibromyoma at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Five hundred and sixty-nine consecutive cases of histologically confirmed uterine fibroid over a ten-year period were reviewed. Uterine fibromyoma constituted 13.4% of gynaecological admission and was responsible for 26.2% of major gynaecological surgery. Majority of the patients (78.4%) were aged between 30 and 44 years and 60.8% were of low parity (0-2). The common presentations were menstrual disorders (64.3%), infertility (56.2%) and lower abdominal swelling (35.5%). Hypertension was present in 26.5% and 42% were obese. Pelvic adhesion was noted in 58.9% of patients. Total abdominal hysterectomy was the surgical procedure in 52% of cases. Pyrexia (32.5%), Anaemia (29.3%), Prolonged hospital stay (24.1%) and Wound infection (20.2%) were the common postoperative morbidities. Fibromyoma at the University of Ilorin Teaching Hospital follows a pattern similar to other parts of the world. It is responsible for a number of gynaecological complaints. Surgery still remains the main mode of treatment.