Less than 2% of gastric neoplasms that are resected surgically are of smooth-muscle origin. Gastric leiomyomas are not encapsulated, and the distinction of benign from malignant leiomyoma may be difficult. Some of these tumors manifest malignant behavior. The histological basis for the diagnosis of benign or malignant smooth-muscle tumor is not entirely satisfactory, and misclassification occurs in some cases. The aggressiveness of those tumors reported as malignant is usually low, and the term "malignant leiomyoma" is usually used rather than the more ominous "leiomyosarcoma." A case is presented of a patient with a 4.5-cm leiomyoma of the gastric antrum resected by the laparoscopic approach. Four laparoscopy trocars were used and multiple applications of the Endo-GIA were needed. Satisfactory margins of resection were obtained. The patient made an excellent recovery with minimal pain. She promptly returned to work and full physical activity.