A case of pulmonary leiomyoma is presented. A 61-year-old asymptomatic woman underwent surgical resection of the lung for definite diagnosis of abnormal shadow on chest X-ray. Her history was hysterectomy and bilateral salpingo-oophorectomy performed 25 years previously because of uterine myoma. Histologic findings of pulmonary lesion was leiomyoma, and nuclear atypia and mitotic figures were not found. Pulmonary smooth muscle neoplasms are exceptionally rare. We review pulmonary leiomyoma reported in the Japanese literature, and also discuss the diagnostic problems in relation to metastasizing leiomyoma of the uterus.