Context: Uterine fibroids also called myomas or leiomyomas are monoclonal tumors of the smooth muscle cells of the uterus Objective:We performed a systematic review and meta-analysis to determine the efficacy of ulip¬ristal acetate (UPA), for the pharmacological management of uterine fibroids. Methods: Systematic review. A search strategy was developed using the following terms: “ulipristalacetate”, “UPA”, ”uterinemyoma”, “fibromyoma” and “fibroid tumor” as text words and Medical Subject Headings (i.e., MeSH and EMTREE) and searched MEDLINE, EMBASE, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Biomed Central, Web of Science, IBECS, LILACS, Congress Abstracts, and Grey literature (Google Scholar and the British Library) for studies published from January 2000 to December 2016. Patients: patients with uterine fibroid. Interventions: ulip¬ristal acetate. Main Outcome: Vaginal bleeding and %). Fibroid volume . Measurements and main results: We identified 438 references after our search. A total of 106 studies were potentially relevant after initial screening. Three primary studies, involving 291 patients, met the inclusion criteria and were included. Vaginal bleeding was reduced (RR = 0.23, 95%CI: 0.18-0.30; p < 0.001; I2: 0%). Fibroid volume was reduced (RR = 0.63 95%CI: 0.40-0.99; p < 0.04; I2: 74%). Conclusion: UA is accepted for long-term intermittent treatment in moderate to severe symptoms of uterine fibroids of adult women in reproductive age. The dose of 5 mg for three months with drug intervals is recommended.