A case of myxoid leiomyoma of the vulva in a 29-year-old pregnant woman was encountered. The leiomyoma was a well-circumscribed solitary mass measuring 4 x 4 x 4.5 cm and, microscopically, composed of spindle-shaped cells and an abundant matrix characterized by a myxoid change. These spindle-shaped cells were arranged in a plexiform pattern. The cytological findings on the aspiration biopsy and the histological features were well correlated. Review of the reported smooth muscle tumors of vulval origin indicates that the myxoid change occurs invariably in younger women and, in some cases, association with pregnancy is suggested.