Background: The major presenting symptom of uterine arteriovenous fistulas is massive, torrential vaginal bleeding, the degree of which often leads to a shock state. Case: A 35-year-old woman, gravida 3, para 2 presented with massive vaginal hemorrhage at the first menstruation six months after delivery. Uterine arteriovenous fistulas were diagnosed by color Doppler ultrasonography (US), dynamic computer tomography (CT), and conventional angiography. The patient underwent hysterectomy after bloodstream decrease by bilateral uterine artery embolization. Conclusion: The extent of uterine arteriovenous fistulas was diagnosed by color Doppler US, CT, and pelvic angiography, and this precise evaluation led to an adequate therapeutic strategy for uterine arteriovenous fistulas.