Two cases of leiomyosarcoma of the spermatic cord are described. The first case is a seventy-eight-year-old white man with a twenty-year history of leiomyosarcoma of the cord. Twice irradiated, he has had some twenty local recurrences. These have been to the contralateral cord, scrotum, suprapubic region, both inguinal regions, and the penis. The second case is a seventy-three-year-old white man who had radical orchiectomy for leiomyosarcoma of the cord one year ago. The patient remains free of recurrence without other therapy. Other adnexal sarcomas are described, the literature is reviewed, the usefulness of retroperitoneal lymph node dissection discussed, and a plan for therapy and follow-up proposed.