A 60-year-old male presented with nine-month history of pain and progressively increasing swelling over the dorsomedial aspect of the right foot. It started as a small painful swelling over the dorsum of the foot. The patient developed a non-healing fungating ulcer at the biopsy site during the course of disease (Figures 1a and b). There was no history of trauma, fever or discharging sinus, and no history of any other swelling in the body. There was no history of radiation exposure. The patient was non-diabetic and did not present with any other systemic ailment. On examination, a diffuse, hard swelling about 10×15 cm was present over the dorsomedial aspect of the right foot. A fungating ulcer, about 4×4 cm in size, was present over the swelling. There was full range of motion of the ankle. Examination of the chest and abdomen was normal.Plain radiograph of the foot showed a poorly defined lytic lesion with complete destruction of the first metatarsal bone extending into the surrounding tissues, second metatarsal, medial and middle cuneiform (Figure 2). AbstractIntroduction: Primary leiomyosarcoma of bone is a rare entity which has never been reported in the foot. We report a case of primary leiomyosarcoma of metatarsal bone.