Purpose <p>The study aimed to determine the anatomical location of uterine fibroids and describe the clinical characteristics of Sudanese women undergoing surgical intervention at Omdurman Maternity Hospital.</p> Methods <p>A retrospective hospital-based study was carried out over a 7-month period from July 2020 to February 2021 including 73 cases of uterine fibroids, that had been surgically excised. Information regarding sociodemographic, clinical and anatomical location was extracted from hospital records. The data were analyzed using SPSS version 24 and expressed as frequencies and percentages.</p> Results <p>The largest number of cases were in women aged 35–39 years comprising an overall percentage of 43.8%. The most common type was intramural fibroids (30.0%), followed by mixed subserosal and submucosal fibroids (25.8%). Posterior wall fibroid location was most common (30.1%) and defined as multiple wall involvement (34.3%). The number of cases presenting with heavy menstrual bleeding were the majority (62.0%), abdominal lump (23.0%) and pressure symptoms (12.0%).</p> Conclusion <p>The results of predominantly intramural and posterior wall fibroids represent a pattern in the cohort of Sudanese women who presented with symptomatic disease requiring surgical intervention. Knowledge of distributions of fibroid anatomy can also enhance recognition for diagnosis and help in advance surgical planning in resource constrained contexts.</p>