Objectives:　To　compare　the　efficacy　and　safety　of　percutaneous　microwave　ablation　(PMWA)　and　transcervical　resection　of　myoma　(TCRM)　for　submucosal　fibroids.Methods:　From　January　2019　to　January　2021,　we　conducted　a　randomized　controlled　study　involving　patients　with　symptomatic　uterine　submucosal　fibroids.　Questionnaires　were　also　used　to　measure　the　uterine　fibroid　symptom　(UFS)　scores　and　quality　of　life　(QoL)　scores　before　and　after　treatment　at　3,　6,　and　12　months.　Outcomes,　adverse　events,　hemoglobin　recovery,　and　submucosal　fibroid　volume　of　both　groups　were　also　compared.　Operation　time,　amount　of　bleeding,　hospital　stay　time,　and　occurrence　of　complications　were　compared　in　groups　with　fibroids　of　different　lengths.Results:　Follow-up　after　surgery　showed　that　UFS　scores　at　3,　6,　and　12　months　were　significantly　lower　in　each　group,　while　QoL　scores　increased　significantly.　For　fibroids　less　than　3　cm,　surgical　time　was　34.2　+/-　9.9　min,　incidence　of　perioperative　complications　was　4.2%,　and　both　decreased　significantly,　compared　to　the　surgical　time　of　the　PMWA　group　(40.0　+/-　8.1　min)　and　incidence　of　perioperative　complications　(24%;　p　＜　.05　for　both).　For　uterine　submucosal　fibroids　＞　5　cm,　the　operation　time　in　the　PMWA　group　was　92.7　+/-　16.0　min,　intraoperative　bleeding　volume　was　22.7　+/-　6.4　mL,　and　hospital　stay　was　2.7　+/-　1.1　days,　which　were　significantly　less　than　the　procedural　time　(107　+/-　11.9　min),　intraoperative　bleeding　loss　(45.9　+/-　12.8　mL),　and　length　of　hospital　stay　(5.0　+/-　1.1　days)　in　the　TCRM　group.　The　differences　were　statistically　significant　(p　＜　.05).Conclusions:　PMWA　and　TCRM　were　both　effective　treatments　for　uterine　submucosal　fibroids.　For　fibroids　shorter　than　3　cm　in　length,　especially　pedicled　submucosal　fibroids,　TCRM　has　absolute　advantages;　however,　for　uterine　submucosal　fibroids　＞　5　cm,　PMWA　avoids　perioperative　complications,　such　as　uterine　perforation,　water　poisoning　syndrome,　and　the　need　for　repeat　surgery,　and　is　considered　the　preferred　mode　of　treatment.　Therefore,　personalized　treatment　should　be　used　for　different　patients　with　uterine　submucosal　fibroids.