OBJECTIVE: We report a new case of bladder leiomyosarcoma in an old patient.METHODS: We present the case of a 75-year-old man with bladder leiomyosarcoma treated by partial surgery followed by adjuvant treatment.RESULTS: Partial surgery of the primary tumor followed by concomitant chemo-radiotherapy was the approach for this patient. Nowadays, patient is free of tumor and living without any problems.CONCLUSIONS: Bladder leiomyosarcoma is an uncom-mon tumor (only about 1% of all bladder cancers) treated ba-sically with radical surgery. Nowadays, partial surgery is a usual approach in other tumors and there is a trend toward less aggressive surgery with preservation of function (such as head and neck cancer, bladder cancer).