Leiomyomas of the bladder are rare tumors with benign behavior. The strategies for diagnosis and treatment are not standard and based generally on case report or insignificant data. We present 4 cases of these tumors, 2 in women and 2 in men, aged from 34 to 72 years (mean 55 years). Patients presented microhematuria in 2 cases, disuria in 1, and 1 with pelvic disconfort irradiated to the vagina. Cystoscopy in all showed bladder tumors covered by normal epithelium. The treatment based on transurethral ressection (incomplete in one case) with uneventful follow up, after period varying from 6 months to 7 years. We reviewed and discussed the most significant reports of the literature.