Leiomyomas can occur in various organs and tissues throughout the body, but reports of their occurrence in the hepatorenal space are rare. The video presents a comprehensive breakdown of the diagnostic procedures and surgical resection procedures. Emphasizing the key strategies for easy misdiagnosis. For leiomyomas occurring in rare sites, the compression on surrounding organs often leads to blurred boundaries in imaging, making it difficult to determine their origin and resulting in misdiagnosis. For rare tumors located at the junction areas, in order to achieve better treatment outcomes, abdominal exploration and intraoperative multidisciplinary consultations should be carried out under sufficient preoperative preparations.