Objectives: Uterine leiomyomas are the commonest benign tumors in women. Myomectomy is preferred for symptomatic uterine leiomyomas when a patient wants to stay fertile. Abdominal myomectomy can be complex and lead to complications. This study examined the usefulness of preoperative ultrasound (US) scans prior to myomectomy to enhance outcomes. Materials and Methods: This retrospective, hospital-based case-control review evaluated surgical outcomes after myomectomies when surgeons themselves performed preoperative US scans in a cases group. The study was at the University of Cape Coast Hospital, Cape Coast, Ghana, from January1, 2018, to December 31, 2020. Data were extracted from the hospital records and analyzed with a Statistical Package for Social Sciences (SPSS version 21.0). Results: The mean ages were 34.5 years and 33.2 years for cases and controls, respectively. abnormal uterine bleeding and infertility associated with uterine fibroids were the commonest indications for myomectomy (88.5% and 70.8%, respectively). The mean duration of surgery was 98.63 minutes for the cases, which was statistically lower than for the controls (115.41 minutes). The number of incisions on the uterus and the frequency of blood transfusion was higher in the controls. There were no significant differences in postoperative complications and durations of hospital stays between the cases and controls. Conclusions: Preoperative US helps reduce surgery duration, incisions on uteri, blood transfusions (which can be correlated to blood loss); yet, there are no proven reduced hospital stays and postoperative complications. Surgeons should perform US scans before surgery. (J GYNECOL SURG 40:54) [ABSTRACT FROM AUTHOR]