Introduction: Uterine fibroids can adversely affect the quality of life of women of reproductive age. Symptomatic fibroids are managed medically or surgically. Medical treatment of fibroids includes selective progesterone receptor modulators (SPRM) like ulipristal and mifepristone and GnRH analogs, which reduce bleeding and inhibit the growth of Leiomyoma. At present, ulipristal and GnRH analogs are available in India for medical management which are expensive and associated with side effects which precludes their long use. Mifepristone is used as an off-label indication in medical management of fibroid. This study was conducted using 5 mg dose to see efficacy in reducing blood loss in symptomatic fibroids and associated side effects. Materials and methods: A single arm interventional clinical trial was conducted at a tertiary Government Hospital in New Delhi enrolling 70 women aged 14–49 years, having fibroids causing heavy menstrual bleeding (AUB-L). Uterine size >14 weeks, suspected or confirmed uterine malignancy and those with severe medical disease were excluded. Study participants were given 5 mg oral mifepristone daily for 3 months. The primary outcome studied was reduction in uterine bleeding measured by pictorial blood loss assessment chart (PBAC) at 1, 3, and 6 months. Reduction in fibroid size, uterine volume, and endometrial thickness was measured by ultrasonography at 3 months. Side effects were noted and at 6 months of enrollment PBAC was further assessed for any residual effect. Results: A total of 49 (70%) and 55 (78.5%) women were found to be amenorrheic after 1 and 3 months of starting mifepristone, respectively. After 3 months, there was a statistically significant improvement of 21.6% in hemoglobin (p < 0.0001). There was statistically significant reduction in fibroid and uterus volume (p = 0.005 and 0.046, respectively). No significant change in endometrial thickness was noted. The side effects reported were minor. Conclusion: Low-dose mifepristone can be considered as an effective, safe, and cheap alternative for medical management of myoma-related abnormal uterine bleeding as well as for preoperative correction of anemia.