Leiomyoma of the fallopian tube is extremely rare. Most cases are asymptomatic and found incidentally at autopsy or unrelated operation. These leiomyomas tend to be singular, small, and unilateral, with a resultant rare preoperative diagnosis. They are often managed with laparotomy, as seen in the literature review. Therefore, preoperative imaging is never reported. We describe a case of leiomyoma of the fallopian tube, which was suspected before operation and treated by laparoscopic approach. Transvaginal ultrasound clearly showed a hypoechoic solid mass separate from the left ovary and uterus in a 44-year-old woman. Color Doppler ultrasound detected low impedance flow in this mass. Diagnostic laparoscopy and the follow-up laparoscopic salpingoectomy revealed a primary leiomyoma of the fallopian tube. We conclude that powerful ultrasound could be helpful in diagnosing rare gynecologic disorders but laparoscopy can be used for definite diagnosis and management of such disorders.