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Adenomatoid tumours are benign neoplasms of mesothelial origin that most often occur in the epididymis in men and the uterus or fallopian tubes in women. When the stromal smooth muscle component is prominent, the term leiomyoadenomatoid tumour is recommended. To date, only 10 cases of epididymal leiomyoadenomatoid tumour have been reported. In some cases, coagulation necrosis associated with worrisome regenerative changes can occur and leads to an increase in diagnostic pitfalls such as malignant neoplastic processes. Pathologists should be aware of this entity to avoid misdiagnosis. Herein, we present the eleventh case of epididymal leiomyoadenomatoid tumour in a 59-year-old man.