HighlightsVascular smooth muscle tumours are rare entities. Majority of these are malignant.Differentiation between a vascular – leiomyoma and a leiomyosarcoma is chiefly upon histopathological examination. Imaging alone is non-contributory.The rarity of the tumour makes predicting the prognosis a challenging prospect.Renal Leiomyomas do not show aggressive behaviour and excellent prognosis is predicted post nephrectomy.An eight-year long charting of progress of leiomyoma in our case has demonstrated the non-malignant potential of such tumours.

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