Aim: To compare efficacy and safety of Mifepristone and Ulipristal acetate in the treatment of symptomatic uterine fibroids. Material and method: This comparative prospective study was conducted in the Department of Obstetrics & Gynaecology among 120 patients comprised of non-pregnant and non-lactating females of age 25-50 years with symptomatic fibroids coming to the department OPD. The selected subjects were divided into two treatment arms i.e. GROUP 1): Ulipristal Acetate: 5mg OD for 3 months and GROUP 2): Mifepristone: 25mg OD for 3 months. Detailed menstrual and obstetric history was recorded. At each visit, examination of the patient was done. PBAC Score and Universal Pain Assessment Score was explained to all participants to be recorded during study period. Complete haematological with biochemical screening was done including haemoglobin, haematocrit, total leucocyte count, differential leucocyte count, ESR etc. Results: Treatment of symptomatic fibroids by Mifepristone as well as Ulipristal acetate was associated with reduction in fibroid size, reduced blood loss and decreased pain. It was found that overall Mifepristone was found to be more effective compared to Ulipristal acetate. Conclusion: We conclude from this study that both these drugs can be used for treatment of symptomatic fibroids. Mifepristone should be preferred over Ulipristal acetate for treatment of symptomatic fibroids.