This is the first time a large endovesical leiomyoma of the urinary bladder has been reported in India. A 44-year-old woman had painless gross haematuria, increased urine frequency, an incomplete emptying feeling, and left loin discomfort. Imaging and cystoscopy revealed a 6 x 5 cm projecting endovesical tumour emerging from the bladder's base near the left vesico-ureteric junction. Transurethral bladder resection with few biopsies was performed, histopathological examination revealed a pathological diagnosis of a leiomyoma of the urinary bladder. Intravesical complete excision of the tumor was performed after ligating its pedicle. Complete surgical resection is a very effective treatment, associated with almost no recurrence. We discuss the relevant recent literature of bladder leiomyoma.