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A 74-year-old man visited a nearby hospital because of vomiting and abdominal pain. An abdominal CT scan revealed a tumor measuring 35mm in the terminal ileum, accompanied by calcification, as well as dilation of the proximal small bowel. Four years earlier, a similar tumor was incidentally pointed out, but no further investigation was conducted at that time. Although the size of the tumor had not increased since the previous examination, the patient had developed bowel obstruction, requiring surgical intervention after improvement of bowel distension. Since the possibility of malignancy could not be ruled out, a laparoscopic ileocecal resection was performed, including lymphadenectomy of the surrounding small bowel mesentery. Macroscopic examination of the resected specimen showed a yellowish, well-circumscribed lesion with calcification inside. The histopathological examination revealed a nodular lesion measuring 40×35×32 mm, primarily involving the muscularis propria in the terminal ileum. The tumor was positive for desmin and α-SMA, while c-kit was negative by immunohistochemical staining and leiomyoma was diagnosed. The patient was discharged on the 7th postoperative day. At the one-year follow-up, no recurrence of the leiomyoma was observed. [ABSTRACT FROM AUTHOR]