The normal anatomy and congenital anomalies of the uterus are described using the new classification proposed by the European Society of Human Reproduction and Embryology (ESHRE) and the European Society for Gynaecological Endoscopy (ESHE). Ultrasound and detailed MRI technique of the uterus are included. The classification of uterine leiomyoma is described according to the FIGO classification. Complications of leiomyoma and pathways to differentiate them from sarcomas are discussed. Adenomyosis is the uterine form of endometriosis responsible for intense dysmenorrhea and can be diffused or localized and needs to be differentiated from leiomyoma. Endometrial polyps and submucosal leiomyoma are a common cause for menometrorrhagia and can be diagnosed with ultrasound and MRI. Deep endometriosis corresponds to the presence of endometrial cells surrounded by stromal tissue outside the uterus and is responsible for chronic pelvic pain. Possible localizations in the pelvis include the retrocervical area, the posterior vaginal cuff, the uterosacral ligaments, as well as the bladder and bowel wall.
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