Background: Leiomyoma occurs in 20–50% of women and represent the most frequent gynecologic tumor. Leiomyoma arising from extra peritoneal round ligament of uterus is very rare. We report a rare case of Leiomyoma of extra peritoneal round ligament presenting as inguinal hernia.
Case Report: A young premenupausal female presented with painful, right groin mass. Physical examination revealed a firm, non-tender, partly reducible swelling in the right groin. Exploration of right groin confirmed 3 cm firm to hard mass in the inguinal canal, which was completely excised. Histology confirmed benign Leiomyoma with focal myxoid degeneration and necrosis. At one year after operation, she remained well.
Conclusions: This case illustrates the ubiquitous distribution of smooth muscle neoplasms and high lights the potential pitfalls for diagnosis, when they occur in unusual location. High index of suspicion is needed.

Keywords: Round Ligament, Leiomyoma, inguinal hernia