Abstract Hereditary leiomyomatosis and renal cell cancer (HLRCC) is a rare cancer predisposition syndrome in which uterine leiomyomas (ULs) are common, morbid, and often precede renal cancer diagnosis. We synthetized evidence on the clinical presentation, pathology, management, and reproductive outcomes of HLRCC-associated ULs. MEDLINE, Embase, Scopus, Web of Science Core Collection, and ClinicalTrials.gov were searched for peer-reviewed studies reporting original data on ULs in HLRCC.