Adenomyosis is increasingly common up to 20% to 30% of reproductive-aged women who present with menorrhagia, dysmenorrhoea, infertility, and related pregnancy complications. It is often diagnosed by the clinical symptoms and ultrasound examinations. MRI, if available, will give a more detailed confirmation of adenomyosis. There are many medical treatments available for adenomyosis, e.g., oral contraceptives, LNG-IUS, GnRH-a, and progestin, while surgery is often either conservative adenomyomectomy or hysterectomy. All these treatments either impact on the fertility of these patients or not readily accepted by them because of the invasiveness of the surgery and side effects of medication. High Intensity Focused Ultrasound (HIFU) ablation treatment discussed in the paper offers an alternative non-invasive treatment for adenomyosis. The early results of HIFU ablation are satisfactory and well accepted by patients. However, long term follows up, with a combination of medical treatments after HIFU ablation, may offer a new treatment solution for adenomyosis.