Angioleiomyomas are benign solitary soft-tissue tumors that originate from the vascular smooth muscle of vessels and rarely occur in the hand. Pain and tenderness are the only clinical characteristics. This report presents a rare case of angioleiomyoma arising from both the superficial palmar arch and a concomitant vein of the artery. The MRI findings lack specific radiological features. However, three-dimensional magnetic resonance angiography demonstrated the existence of a relationship between the tumor and its feeding vessels. The diagnosis was made after a histopathological study of the tumor. Adequate collateral circulation should be confirmed both before and during surgery if the lesion occurs within an artery. Angioleiomyoma should therefore be included in the differential diagnosis of painful vascular tumors with no neurological findings in the hand.