Adenomyosis is a benign gynecologic condition of the uterus similar to uterine leiomyoma (fibroids), but with different pathophysiology and prevalence. The treatment algorithms for symptomatic adenomyosis are not as established as for uterine fibroids and other gynecologic conditions. Uterine artery embolization (UAE) is a well-recognized treatment for symptomatic uterine fibroids. This minimally invasive therapy has been likewise effective for symptomatic adenomyosis but with nuances in UAE protocol and outcomes. There is also less quality evidence to garner support for generalized use of the procedure for symptomatic adenomyosis. Many factors contribute to this lack of data, and efforts to clarify the utility of UAE in adenomyosis will need to address a classification system and standardization of technique.