Sarcomas of the bladder in adults are rare, representing less than 1% of all malignant bladder tumors. Leiomyosarcomas are the most common sarcoma occurring in the bladder in adults. Immunohistochemical studies play an important role in the diagnosis of this tumor. Wide surgical excision with adjuvant chemotherapy is the mainstay of treatment. Herein, we report on 3 cases with leiomyocarcoma of the urinary bladder and review the literature.