Background and Objective: Among Zambian women, uterine fibroids are the most common benign gynaecological tumours, causing significant morbidity and infertility. There is inadequate information demonstrating a link between the sonographic features of uterine fibroids and blood oestrogen levels, despite theories suggesting oestrogen as the main risk factor. The study aimed to explore the relationship between the profiled sonographic characteristics of uterine fibroids and oestrogen hormone levels in women of reproductive age (15-49 years) at Levy Mwanawasa University Teaching Hospital (LMUTH), Lusaka, Zambia. Methodology: This was a quantitative, cross-sectional study. One hundred and forty-two reproductive-age women confirmed to have uterine fibroids on ultrasound were recruited. An ultrasound was performed, followed by a laboratory test for oestrogen levels. A questionnaire was also used to obtain participants' demographic, uterine fibroid sonographic characteristics and oestrogen hormone levels. Descriptive and inferential statistics were run for the analysis. Results: The median age was 33years (IQR 29-38), and the BMI median was 30 (IQR 24.6-35). The majority of the participants were either overweight or obese (61.1%). Furthermore, the majority were nulliparous (35%) and had a positive family history of fibroids (61%). The prevalence of elevated oestrogen levels among uterine fibroid participants was 61.3% (N=87/142). There was a statistically significant association between the size of UFs and oestrogen level (r = 0.844, p = 0.001), statistically significant positive relationship between submucosal UFs and oestrogen hormone level (r= 0.513, p = 0.001). There was a significant positive relationship between hypoechoic fibroids and oestrogen hormone level was observed (r=0.290, p = 0.001), the number of UFs against oestrogen level showed a strong positive relationship (r=0.710, p= 0.001). Conclusion: The study reviewed that there is a correlation between oestrogen