Leiomyoma of the bladder is a very rare disorder that accounts for 0.43% of all bladder neoplasms. Although the pathophysiology of the bladder leiomyoma is unknown, there are some theories on it. The patients can be asymptomatic; when present, clinical symptoms (lower urinary tract symptoms and\or hematuria), are associated with tumor size and location. For diagnosis, imaging plays an important role: ultrasound, computed tomography (CT) scan and magnetic resonance imaging (MRI) are the examinations most frequently performed. Treatment consists of surgical removal of the tumor, and the prognosis is excellent.