Objective — to study the expression of vascular endothelial growth factor (VEGF) in the dominant myomatous nodule and perifocal myometrium. Subject and methods. 38 reproductive-aged female patients were divided into 3 groups according to the degree of fibrosis of the dominant myomatous nodule. VEGF expression in the dominant nodule and perifocal myometrium was immunohistochemically evaluated. Results. Automated image analysis of the dominant nodules differing in the degree of fibrosis showed that the proportion of a collagen matrix was 13.50±2.08, 39.54±4.32 and 84.79±6.42% in Groups 1, 2, and 3, respectively. The highest and lowest of VEGF-A expression levels in the endothelium and tumor myocytes were found in grades I and III fibrosis (p=0.021). VEGF-A expression in the perifocal myometrium increased significantly (p=0.008) with the higher degree of nodular fibrosis. Conclusion. The reproductive-aged patients with uterine leiomyoma showed an inverse correlation between the expression of VEGF-А in the dominant nodule and the degree of its fibrosis. There were significant relationships between the expression of VEGF-А in the dominant nodule and that in the perifocal myometrium. The authors declare no conflicts of interest.