To determine if a large uterus will shrink after fibroid resection and ablation, 32 women with hypermenorrhea underwent fibroid resection and a minimum of 9 months' follow-up (mean 9 mo-3.5 yrs). Uterine measurements were determined by bimanual examinations before and after the procedure. The women's perceptions of menstrual flow and dysmenorrhea were compared at those time points. After a minimum of 6 months' follow-up, the uterine cavity size decreased by 3 to 8 weeks in 79% of women, menstruation was reduced to either amenorrhea or hypomenorrhea in 88%, and pain was relieved in 76%. Outpatient endometrial resection and ablation is an effective procedure to decrease uterine size and relieve the associated sign of hypermenorrhea.