Benign metastasizing leiomyoma is a rare disease that primarily affects premenopausal women who have a history of uterine leiomyoma, which is characterized by pulmonary metastases. The pathogenesis of this condition is unknown. Patients are usually asymptomatic or have vague symptoms. Pathological examination in conjunction with immunohistochemistry is required for diagno-sis. Treatment is determined by the patient's age, hormonal status, symptoms, and the extent of the lesions (number, size, and location of nodules), with surgical resection being the most effective. We present the case of a 72-year-old woman who had a total hysterec-tomy 30 years earlier due to myomas and developed a persistent dry cough. Her computed tomography of the chest revealed several small nodules in the pulmonary parenchyma. Because of the nod-ules' small size and difficult accessibility, a surgical biopsy was per-formed for histopathological examination and immunohistochemi-cal staining, which revealed metastasizing leiomyoma. Letrozole treatment was started and was well tolerated.