Objective — to clarify the clinical features of adenomyosis in patients with acromegaly. Subject and methods. The clinical course of adenomyosis was analyzed in 26 patients with acromegaly versus 214 patients with adenomyosis without acromegaly. The mean age of the patients was 41.8±4.1 and 48.6±6.1 years, respectively. The diagnosis of adenomyosis was based on clinical, laboratory, and ultrasonographic findings. Results. Euthyroidism and normal coagulation were confirmed in all the patients. The found significant differences of the course of adenomyosis in acromegaly included preserved complaints of heavy menstrual bleeding (36.6% of the patients) in the presence of rare complaints of algomenorrhea (13.6%), chronic pelvic pain (3.8%); clinical adenomyosis remission periods that coincided with oligo-/amenorrhea (45.5%), as well as the prevalence of isolated uterine lesion among patients with complaints of abnormal uterine bleeding. Conclusion. The molecular basis of menorrhagia in the absence of complaints of pain syndrome in uncommon adenomyosis in the presence of acromegaly calls for further investigation.