Objective To investigate the pregnancy status and influencing factors of patients with uterine fibroids after high-intensity focused ultrasound(HIFU) therapy, and to provide theoretical basis for optimizing the treatment of patients with uterine fibroids. Methods Ninety-eight patients with fertility requirements who underwent hysteroscopic surgery for uterine fibroids from June 2014 to June 2017 were enrolled. Regular follow-up was conducted to understand postoperative pregnancy and obstetric complications. Results (1) As of June 2018, 98 patients in this study had a total of 71 patients with 89 pregnancies. There was significant difference in age and infertility between the pregnant group and the non-pregnant group (P<0.05). There was no significant difference in the size of fibroids, type of fibroids and maternal parity (P>0.05). (2) 89 pregnancy outcomes were 68 births (21 births, 47 cesarean section), 9 spontaneous abortions, 4 abortions, 1 induction of abnormality in mid-pregnancy, 1 ectopic pregnancy, and 6 cases of pregnancy. (3) There were 12 complications in 68 births, including 2 cases of premature delivery, 2 cases of central placenta previa, 3 cases of marginal placenta previa, 2 cases of placenta implantation, and 3 cases of placenta adhesion. (4) Obstetric complications of submucosal fibroids were significantly increased compared with the other groups, the difference was statistically significant (P<0.05), mainly manifested as placenta previa, placental adhesion and placenta implantation. Conclusion HIFU is safe and effective in the treatment of uterine fibroids. It can be used as a new option for the treatment of uterine fibroids in patients with fertility requirements.