Objectives: To describe the clinicopathological characteristics of the scrotal bizarre leiomyoma in order to increase our understanding, and avoid the possibility of erroneous diagnosis and treatment.

Results: We report the case of a 43 year-old patient with a pendulous nodular scrotal tumour, which after microscopic study could be seen to be of smooth muscular origin, corresponding, because of its peculiar histological characteristics, to the rare variety called atypical or symplasmic bizarre leiomyoma.

Conclusion: Although it is a form of leiomyoma which is extremely infrequently found in the scrotum, it is necessary to know it can occur and to know that we are dealing with a benign tumour that should be treated as such.

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