Abstract: Objective: The aim of this study was to investigate the diagnostic utility of DCE-MRI combined with DWI in differentiating various pathological types of uterine fibroids. Method: Fifty MRI scans were retrospectively acquired in patients with uterine fibroids, including both DCE-MRI and DWI scans. In cases of multiple fibroids, the one with the largest volume was selected for analysis. Fibroids were confirmed in all patients using postoperative pathology, and were categorized into common (27 cases), rich-cell (6 cases), and degenerative (17 cases) types. The diagnostic performance of DCE-MRI, DWI, and their combination across different pathological types was assessed. Results: MRI accurately localized the fibroids, identifying 15 subserosal, 27 intramural, and 8 submucosal fibroids. In DWI, rich-cell-type fibroids exhibited significantly higher signal intensity and lower Apparent diffusion coefficient (ADC) values compared to normal and degenerative types; In DCE-MRI, the quantitative parameters K^trans and K^ep were significantly higher in rich-cell-type fibroids than the normal and degenerative types. The combined examination demonstrated significantly higher diagnostic sensitivity compared to individual DCE-MRI or DWI. Conclusion: The application of DCE-MRI combined with DWI showed significant clinical value in the differential diagnosis of uterine fibroids of various pathological types.