Although bladder leiomyoma is rare, this is the most frequent nonepithelial benign tumor of the bladder. Symptoms and treatment depend on location and size of the lesion as well. The optional treatment is a total enucleation or partial cystectomy, although in biopsy proved cases watchful waiting is an option, surgery should be considered as the tumor grows or symptoms are observed. The etiology of bladder leiomyoma is unknown. Uterine leiomyoma is known to be estrogen responsive. The premenopausal women are prevalent in the fourth decade.