To report and highlight the potential diagnostic pitfalls and consequences of leg textiloma.A soft tissue pseudotumor of the left leg diagnosed in a 58-year-old man is described. The lesion was caused by a retained surgical gauze after surgery for varicose veins. The surgical gauze had remained in the subcutaneous tissue for 3 years and led to the formation of a 3-cm, well-circumscribed, pseudotumoral foreign body granuloma which appeared like a soft tissue tumor. A surgical intervention was performed and the mass was excised. During the procedure an old surgical gauze was found. The histologic examination revealed that a large foreign body granuloma (pseudotumor) had developed in contact with foreign material birefracting under polarized light (gauze). No sign of malignancy was noted.Although no fatal complications have been described in the musculoskeletal localization, the diagnosis is difficult and costly. According to clinical presentation, a differential diagnosis should be made between a tumoral lesion, such as a sarcoma, or a pseudotumoral lesion, such as a gossypiboma. Focal myositis or infections should also be suspected.