This study compared the technical success of fibroid devascularization using high-intensity focused ultrasound (HIFU) and radio frequency (RF) to provide an experimental basis for the clinical selection of a suitable, minimally invasive method for treating uterine fibroids. Patients were randomly divided into two groups and treated with HIFU or RF accordingly. The two groups of patients were divided again into subgroups A, B, and C based on fibroid diameter and subgroups A', B', and C' based on fibroid blood supply grades. The fibroid diameters in subgroups A, B, and C were 2.0 cm <or= D < 4.0 cm, 4.0 cm <or= D<6.0 cm and 6.0 cm <or= D<8.0 cm, respectively, and fibroid blood supplies were classified into three grades corresponding to subgroups A', B', and C', respectively. The complete ablation rates of the two treatments were compared by contrast-enhanced ultrasound. Both treatments were effective, but the general complete ablation rate of RF was higher than that of HIFU (p < 0.05). The comparison between the two treatments in subgroup A and subgroup A' showed that the complete ablation rate of HIFU was as good as that of RF (p > 0.05). In other subgroups, the complete ablation rates of RF were better than those of HIFU (p < 0.05). No severe complications were observed after these two treatments. RF can be applied for the majority of fibroids. As a noninvasive therapy, HIFU could be the preferred method for the treatment of small, hypovascular fibroids.