Objective: To study the pregnancy and its prognosis and explore influence factors on pregnancy after Uterine fibroids (UFs) treatment by microwave ablation (MWA). Design：A prospective observational study. Setting: Department of Interventional Ultrasound in a single centre in China. Population: Patient of UFs with fertility desiring. Methods: Each patient with fertility desiring underwent MWA for UFs from August 2010 to September 2020 was interviewed regularly. Main Outcome Measures: Pregnancy situation and outcomes, multiple factors affecting pregnancy. Results:81 women were enrolled in the study. Among them, there were 45 patients with 50 pregnancies. The pregnancy rate was 55.56% (45/81), and the median conception time was 18 months (1–60 months). Natural and artificially assisted pregnancy rates were 48.15% (39/81) and 7.41% (6/81), respectively. The number of pregnancies that ended in spontaneous and induced abortion were 11 and 9, respectively. And 25 pregnancies resulted in deliveries, with 1 of patients having two deliveries. Cesarean sections were performed by 76% (19/25) of the gravida, and 24% (6/25) opted for a vaginal delivery. All the 25 newborns survived and were in good health at the end of the follow-up. 1 case had placental abruptions at 26 weeks gestation, while the others had no serious complications during the perinatal period. For UFs patients with fertility requirements, the patient’s age, history of spontaneous abortion and fibroid types are relevant factors affecting pregnancy after MWA. Conclusions: MWA could be considered a promising clinical treatment for women with UFs and plans for future pregnancy.