Leiomyoma of the urethra is a rare clinical entity. We report an unusual presentation of this tumour, which led to a diagnostic and surgical dilemma. The patient was a 16-year old female who presented with a labial mass which was palpable abdominally. Imaging methods and laparoscopy demonstrated a well defined soft tissue mass arising from the pelvis, without any obvious involvement of the urinary tract. The tumour (8 x 10 cm) was completely excised with reconstruction of the bladder and urethra. Histology confirmed a cellular leiomyoma.