Esophageal leiomyoma represents 60-80% of all benign esophageal neoplasms and rarely has been reported associated with disorder of esophageal motor activity. We discussed here a unique case of patient with leiomyoma of the middle third of the esophagus associated with esophagogastric junction outflow obstruction pattern at high resolution manometry. Thoracoscopic enucleationof a leiomyoma of the esophagus is recommended and the optimal approaches should be tailored based on the location and size of the tumor. Nevertheless the pathophysiology of manometric pattern of esophago-gastric junction outflow obstruction associated with this benign neoplasm has yet to be determined.

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