Introduction: Letrozole, an aromatase inhibitor has been widely used in ovulation induction and in medical management of leiomyoma uterus. Material and Methods: The study was conducted on 30 premenopausal women in the outpatient department of Obstetrics and Gynaecology with symptomatic fibroid uterus. All selected subjects were given tablet Letrozole 2.5 mg per day for 12 weeks, regardless of the day of the menstrual period. While on therapy, the women were called for follow up visits after 4 weeks,8 weeks and 12 weeks. On each visit patient underwent history taking for improvement or deterioration of symptoms, to ascertain compliance and document any adverse effects. Results: Majority of patients (83.3%) did not experience any adverse effect of the drug. 13.3 % patients had nausea and hot flushes was present in only one patient. Conclusion: Letrozole, an aromatase inhibitor is a promising medical management option for medical treatment of fibroids with minimal side effects.