The objective: was to evaluate the possibility of using mifepristone (Gynestril) as a hormonal preparation for conservative myomectomy. Patients and methods. The effect of a three-month course of mifepristone (Gynestril) at a dose of 50 mg per day on the dynamics of clinical indicators, ultrasound, the results of surgical treatment in 30 women of reproductive age with uterine leiomyoma was studied. Results. The use of an antigestagenic drug for preoperative preparation led to a decrease in the incidence of pain syndrome, dysfunction of the pelvic organs in most patients. The presence of amenorrhea in 90% of women contributed to the normalization of hemoglobin. The positive dynamics of the mioma nodes sizes and the uterus made it possible to reduce the time of operative intervention and the volume of intraoperative blood loss. Conclusion. The use of antigestagen preparations, in particular mifepristone (Gynestril), for the purpose of preoperative preparation, allows obtaining the most positive result of organ-preserving treatment of uterine myoma in reproductive age women. Key words: leiomyoma of the uterus, reproductive age, preoperative preparation, mifepristone, Gynestril.