Vascular leiomyoma is a benign tumor of smooth muscle origin that is rarely encountered in the head and neck area. Vascular leiomyoma arising on the external nose is even more uncommon. Surgical excision with histologic study is the only way to make the diagnosis. This article presents an unusual case of vascular leiomyoma arising from the nasal dorsum in one 31-year-old male that was included in that clinicopathologic review to familiarize clinicians with this uncommon benign tumor.