High intensity focused ultrasound (HIFU) treatment of uterine myoma is a non-invasive procedure that uses high intensity, focused ultrasound to heat and destroy the tissue of uterine myoma. The history of using therapeutic ultrasound dates back to the early 20th century, and since, the technique has been continuously improved to an extent that the breadth of its clinical applications, both diagnostic and therapeutic, justify the integral role it plays in medicine today. HIFU treatment requires that ultrasound beams be focused on targeted uterine myoma. Due to significant energy dissipation at the focus, temperatures within tissues increase to more than 65℃, and destroy diseased tissue. This technology can achieve precise "ablation" of myoma tissue, and because it destroys diseased tissue non-invasively, it is also known as "Non-invasive HIFU surgery". Development of this technology significantly broadened the range of treatment options for patients suffering from uterine myoma. Furthermore, in contrast to surgery, HIFU requires only a short period of hospitalization and has a low complication rate. Today, HIFU is being used more frequently to treat adenomyosis, but its increased use has led to the reporting of more complications. Here, the authors report a case of uterine perforation after HIFU ablation for adenomyosis.