Uterine necrosis is one of the rare complications that may follow uterine arterial embolization for postpartum hemorrhage (PPH), and its incidence remains unknown. The authors report four cases of uterine necrosis in Korea. The mean time interval between uterine artery embolization (UAE) and diagnosis of uterine necrosis was 72 days. Patients’ main symptoms were abdominal pain, fever, profuse vaginal discharge, and vaginal bleeding. Decisions related to management depended on the condition of the patient and the patient’s desire regarding conservation of the uterus. Based on these cases, the authors suggest helpful decisions for the therapeutic guidelines for uterine necrosis after UAE.