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Breast leiomyomas are extremely rare and commonly seen in the nipple-areolar complex due to the presence of smooth muscle. Identification of this rare benign tumour is based on its location and the presence of spindle cells on histology. We report a case of a breast leiomyoma in a female patient who had a six-year history of a unilateral breast mass. Breast ultrasound and mammography demonstrated a sub-areola mass and an ultrasound-guided core biopsy revealed a benign spindle cell neoplasm with smooth muscle differentiation. The lesion was excised and final histology confirmed a leiomyoma with clear margins.

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