Uterine fibroids are a significant cause of morbidity for women of reproductive age. Over the past decade, minimally invasive treatment options are becoming increasingly popular. A new, Food and Drug Administration-approved noninvasive treatment option is magnetic resonance-guided focused ultrasound surgery, which has the potential to become a treatment of choice for selected patients. We review the technical aspects of the procedure of magnetic resonance-guided focused ultrasound surgery for treatment of uterine fibroids, potential difficulties with treatment planning, and clinical trial results to date. We also describe current developments in treatment imaging and treatment optimization.