Abstract: Uterine leiomyoma is the most common benign tumor in women of childbearing age. As a minimally invasive treatment technique, the high-intensity focused ultrasound (HIFU) has been widely used in the treatment of uterine leiomyoma, but the ablation efficiency is low for some special types of leiomyoma, so as to cause a lot of serious complications. This kind of leiomyoma has its special manifestations in the images of two-dimensional gray-scale ultrasound, Doppler ultrasound and contrast-enhanced ultrasound. A review of the role of the above ultrasound imaging methods in predicting the efficacy of HIFU treating uterine leiomyoma is made in this article. However, there are certain errors in various ultrasound imaging techniques, and the information of microvascular perfusion in uterine leiomyoma is still incomplete. To provide more reference and information for predicting the efficacy of HIFU treating uterine leiomyoma, multimodal analysis including superb micro-vascular imaging (SMI), contrast micro-imaging (CMI) and magnetic resonance imaging (MRI) can be used in future research.