There are many common features between uterine sarcomas - leiomyosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma and adenosarcoma -with regards to course, therapy and follow-up, such as post-menopausal bleeding or additional premenopausal bleeding, as well as rapid growth. There is a new staging system according to FIGO and new therapy recommendations according to NCCN. Prior to therapy, imaging staging of the pelvis, abdomen and chest should be carried out due to the frequency with which metastases are found at the time of diagnosis. In the case of disease spread in uterine sarcomas and malignant mixed tumors, good supportive therapy is a possible therapy option instead of chemo- or radiotherapy. The approach - observation, surgery, lymphonodectomy, mono- or polychemotherapy, radiotherapy, hormone therapy - is chosen according to the extent of spread and the resection status. Neoadjuvant therapies are not as yet established.