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Paratesticular leiomyosarcoma is very rare. We report a 72-year-old man with this scrotal tumor. The mass had been painless for eight years, but become painful and larger recently. A non-tender, firm, elastic mass was palpable on the right hemiscrotal wall, measuring 6 centimeters in diameter. The mass was not adhering to the testis or to the vas deferens. We performed a wide excision of the mass. The pathological diagnosis was compatible with a grade-2 leiomyosarcoma. The patient refused postoperative radiotherapy, of which the role remains controversial. He was doing well at nine months of follow-up. Local recurrence and/or distant metastasis have been reported for paratesticular leiomyosarcoma, though this rare tumor is often mistaken as a benign tumor. Long-term follow-up is therefore neces-sary for this case. (JTUA 19:122-4, 2008