Objective — to determine the role of lipid analysis of myometrial tissues and fibroids in the prediction of myomas recurrence. Materials and methods. Lipid analysis of tissue samples of the myometrium and fibroids was carried out in 66 patients in National Medical Reseach Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov: 35 patients with first diagnosed uterine fibroids (UF), 31 — with a diagnosis of recurrence of uterine fibroids (RUF). The material was taken in the 1st phase of the menstrual cycle, along with the morphological study in the removed tissue samples, the lipid composition was determined. Qualitative and quantitative assessment of lipidoma was carried out using electrospray mass spectrometry. Inclusion criteria: reproductive age of patients (18—45 years); the presence of uterine fibroids; reproductive desire, lack of hormone therapy for 6 months or more before surgery. Exclusion criteria: the presence of systemic autoimmune diseases, severe somatic pathology, cancer; infections, including sexually transmitted infections; concomitant gynecological pathology. A semiquantitative assessment of lipid levels was performed by direct mass spectrometry of the lipid tissue extract. The search for statistically significant differences in the level of compounds was carried out using the non-parametric Mann—Whitney test followed by analysis of the involvement of lipids in metabolic pathways using Metabolanalyst 4.0. Results. When comparing the group of newly diagnosed uterine myoma and its recurrence, 144 lipids were detected in fibroids samples and 171 lipids in myometrial samples, the levels of which did not differ in the studied groups. When comparing UF and RUF, significant differences in the levels of glycerophospholipids, sphingolipids, triglycerides, fatty acids were revealed in myoma tissues; in the tissues of the myometrium — the difference in the levels of lipids involved in the metabolism of glycerophospholipids, lipids with an ether bond, sphingolipids. In the tissues of fibroids with relapse, the metabolism of linoleic acid is altered. Conclusion. An elevated level of linoleic acid in the tissues of the fibroids can be considered a prognostic criterion for the recurrence of uterine fibroids. The identification of molecular biological processes in the myometrium and in the fibroids themselves, the determination of the ratio of proliferation and apoptosis processes will expand the understanding of the uterine myoma, of the possible mechanisms of its growth and recurrence. Determination of mass spectrometric significantly differences in the tissues of the fibroids will make it possible to give recommendations regarding further tactics of the patient’s management, rehabilitation treatment and plans for the implementation of the reproductive function.