Uterine leiomyomas, commonly known as fibroids, are one of the most common pelvic tumors found in women. Ultrasonography is the primary modality for evaluating leiomyomas. However, frequently these tumors are not accompanied by symptoms, and they are found incidentally during computed tomographic (CT) examinations performed for other indications. Because leiomyomas may first be noted on CT scans, radiologists should become familiar with their characteristic appearance. The authors describe the CT findings of uterine leiomyomas and their secondary changes, including cystic degeneration, calcification, infection, necrosis, fatty degeneration, and sarcomatous degeneration.