Objective To systematically review the effectiveness and safety of high intensity focused ultrasound (HIFU) for myoma of uterus fibroid. Methods Such databases as PubMed, EMbase, Web of Science, The Cochrane Library (Issue 10, 2012), CBM, CNKI, and WanFang Data were electronically searched from inception to November 2012 for randomized controlled trials on HIFU for myoma of uterus fibroid. Two reviewers independently screened literature according to inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then, meta-analysis was performed using RevMan 5.0 software, and the quality levels of evidence were graded using GRADEpro 3.2 software. Results A total of 6 trials were included, involving 643 patients. The results of meta-analysis showed that, HIFU was similar to surgery in complete and partial fibroid ablation, with no significant difference; HIFU and radiofrequency were different in complete and partial fibroid ablation, with significant differences; and HIFU was superior to mifepristone in complete fibroid ablation, with a significant difference. Conclusion HIFU is an alternative, non-invasive, safe and effective treatment for myoma of uterus fibroid.