BACKGROUND: Uterine artery embolization is a common procedure for symptomatic leiomyomas and is being used as a less invasive alternative to a hysterectomy. This is a report of an uteroenteric fistula after uterine artery embolization. CASE: A 50-year-old woman developed an uteroenteric fistula that was seen on a computed tomography scan 6 months after she had an uncomplicated uterine artery embolization for symptomatic leiomyomas. She was managed surgically with a hysterectomy and small bowel resection with reanastomosis. CONCLUSION: Uteroenteric fistula can occur as a complication of uterine artery embolization for leiomyoma management.