We present a 39-year-old G0P0 with history of infertility treatment-caused ovarian hyperstimulation and uterine fibroids, who was found to have a rare pathological presentation. Peritoneal lesions were identified during laparoscopic treatment for this patient's fibroids. Histological evaluation of these lesions revealed leiomyomatosis peritonealis disseminata (LPD), also known as disseminated peritoneal leiomyomatosis. While LPD can often be confused for metastatic leiomyosarcoma due to the histological presence of fibroblasts, myofibroblasts, smooth muscle, collagen, and spindle cell appearance, cases of LPD are generally benign, and present no need for therapy in asymptomatic cases. We present a discussion based on the clinical and sonographic presentation of LPD, its pathophysiology, treatment options and prognosis. A question set has been designed to reinforce comprehension of this presentation and associated topics for health care professionals.