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Primary ovarian leiomyoma is a rare benign ovarian tumor that occurs in women between the ages of 20 and 65. This tumor is usually diagnosed incidentally through pelvic examination or histopathological study after surgery. A definitive preoperative diagnosis is difficult due to the lack of pathognomonic signs or specific imaging features. Therefore, histopathological examination and immunohistochemical analysis are considered necessary. The authors report a case of a 49-year-old woman with ovarian leiomyoma who had a history of heavy vaginal bleeding. She underwent laparotomy with a preoperative diagnosis of uterine fibroids.