Angioleiomyomas are rare and benign smooth muscle tumors that are infrequently found in the hand. We present a case of angioleiomyoma of the distal ulnar artery that presented with painless mass and gradual enlargement. 3D computed tomography angiography revealed a mass involved with ulnar artery. Surgical excision was performed, and the histology was characteristic of an angioleiomyoma. The patient became asymptomatic after the operation. At 1-year follow-up after the operation, no recurrence has developed. The purpose of this case report is, furthermore, to consider the differential diagnosis in painless masses of the hand.