Objective To investigate the coexistence of endometriosis in women presenting with symptomatic leiomyomas. Design Retrospective study. Setting Tertiary university medical center. Patient(s) We reviewed the medical records of 131 patients who underwent laparoscopic myomectomy or hysterectomy. All patients were consented for possible concomitant diagnosis and treatment of endometriosis. Intervention(s) All patients underwent laparoscopic myomectomy or hysterectomy. Main Outcome Measure(s) The main outcome measure of the study was the presence or absence of endometriosis. Result(s) Of the 131 patients, 113 were diagnosed with endometriosis and fibroids, while 18 were diagnosed with fibroids alone. Patients with fibroids were on average 4.0 years older than those with endometriosis and fibroids (41 vs. 45). Patients with both diagnoses were also more likely to present with pelvic pain and nulliparity than those with fibroids alone. Conclusion(s) An overwhelming majority of patients with symptomatic fibroids were also diagnosed with endometriosis. Overlooking the concomitant diagnosis of endometriosis in these women may lead to suboptimal treatment of the patients. Further studies are needed to evaluate the impact of surgical treatments on symptom resolution.