Abstract
Paraurethral leiomyoma is an exceptionally rare benign smooth muscle tumor adjacent to the female urethra, presenting diagnostic challenges due to nonspecific symptoms like urinary obstruction and dysuria. This case report details the clinical presentation, diagnostic workup, and surgical management of a 45-year-old woman with a paraurethral leiomyoma. Diagnosis involved clinical examination, imaging, and biopsy. The mass was excised via a perineal route without urethral injury, confirmed by histopathology. The patient recovered well, voiding without difficulty postoperatively. This case emphasizes the importance of thorough preoperative counseling, advanced imaging, and multidisciplinary collaboration in managing paraurethral leiomyomas.