Primary leiomyoma of the pleura is extremely rare. A 45-year-old man presented with a complaint of right chest pain. Chest computed tomography demonstrated a solid, round pleural mass in the right anterior chest wall. The mass was completely resected, and histopathological examination revealed a localized primary pleural leiomyoma. The patient was followed and has been disease-free for over 15 months. This is the first report of primary leiomyoma of the pleura in China. A review of the literature on primary leiomyoma of the pleura is presented.