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Paratesticularleiomyosarcomas are rare neoplasms. Radical orchidectomy and high ligation of cord followed by surveillance is the treatment of choice. Here we report a 73-year-old man who presented with a 2-year history of painless lump in the left hemiscrotum. A left radical orchiectomy with high ligation of the spermatic cord was performed. The histo-pathological and immunohistochemistry evaluation revealed a moderately differentiated leiomyosarcoma of paratesticular region. The patient is still alive with no evidence of local recurrence and distant metastasis after seven years of follow-up. _______________________________________________________________________________________ Keywords: leiomyosarcoma; spermatic cord; paratesticular; surgical procedures.