Microwave endometrial ablation is an effective treatment for heavy menstrual loss that achieves high satisfaction rates, is acceptable to patients, and is recommended by the National Institute of Clinical Excellence. It has been evaluated extensively in randomized trials against first- and second-generation endometrial ablative techniques. Its simplicity of use and short treatment time make it suitable for outpatient treatments, whilst it can also treat larger and irregular cavities. This article reviews the available clinical research and scientific basis of this endometrial ablation technique.