Objective：To investigate the differences between South African black women and Chinese Han women with uterine fibroids via a control study and the influence of such differences on the safety and efficacy of high-intensity focused ultrasound （HIFU） ab－lation. Methods：A total of 254 patients who underwent HIFU treatment in Chris Hani Baragwanath Hospital in South Africa or The Fifth Affiliated Hospital of Xinjiang Medical University in China from October 2015 to November 2016 were enrolled，and among these patients，there were 132（399 uterine fibroids） from South Africa and 122（177 uterine fibroids） from Xinjiang. Results：Com－pared with the Chinese Han patients，the South African black women had a significantly higher proportion of patients with multiple uterine fibroids（62.9% vs. 29.5%，P<0.05），a significantly higher body mass index[（24.9±2.0） kg/m2 vs. （23.2±2.6） kg/m2，P<0.05），a significantly greater subcutaneous fat thickness[30.9（18.0，40.0） mm vs. 17.0（15.0，23.0） mm，P<0.05]，significantly longer axes of the uterus[101.6（87.4，125.7） mm vs. 78.0（75.0，88.0） mm，P<0.05] and fibroids[45.3（32.6，63.4） mm vs. 42.0（32.0，58.0） mm，P<0.05]，significantly higher uterine volume[379.9（223.1，607.3） cm3 vs. 137.5（104.5，198.5） cm3，P<0.05 ]，and no significantly differ－ences of uterine fibroids[36.7（15.3，102.1） cm3 vs. 31.6（13.6，70.3） cm3]（P＝0.102），and a significantly higher incidence rate of the clinical symptom of dysmenorrhea（72.0% vs. 9.0%，P<0.05）. There were no significant differences between the two centers in the maximum power，minimum power，average power，irradiation time，and total therapeutic dose of HIFU treatment；the Xinjiang center had a significantly higher treatment intensity than the South African center（518.3±103.3 s/h vs. 442.4±143.1 s/h，P<0.05），and the South African center had a significantly longer treatment time than the Xinjiang center（86.5±55.0 minutes vs. 85.5±45.2 minutes，P<0.05）. Imaging examination during follow-up showed that there was no significant difference in fibroid shrinkage rate be－tween the two groups of patients. The South African center had a higher incidence rate of adverse events than the Xinjiang center，but no serious complications requiring treatment were observed in either center. Conclusion：Although there are differences in body mass index and uterine fibroids between South African black women and Chinese Han women，HIFU with an individualized treat－ment regimen can be safe and effective in the treatment of uterine fibroids. HIFU is suitable for African black women with uterine fibroids.