INTRODUCTION AND IMPORTANCE: Leiomyomatosis peritonealis disseminata is a very rare disease that involves the presence of multiple benign tumors of smooth muscle origin all over the peritoneal cavity. Due to its ability to mimic malignant pathologies, it is associated with significant diagnostic and therapeutic challenges. This case highlights a unique case of LPD to further raise awareness and provide useful information on how to manage this condition. CASE PRESENTATION: A 28-year-old female was admitted with progressive increase in abdominal distension and discomfort. Imaging studies revealed multiple peritoneal nodules that mimicked metastatic disease. Laparoscopic exploration and histopathological examination subsequently confirmed the diagnosis of LPD. She never had a history of malignancy and hormonal therapy, which are the usual associations with this condition. CLINICAL DISCUSSION: Diagnosis of LPD is usually missed because its clinically and radiologically smoky appearance of the belly may mimic peritoneal carcinomatosis. Pathogenesis includes hormonal factors, though rare cases are idiopathic. Symptomatic nodules are usually treated with surgical excision and in recurrent cases, attempts at hormonal manipulation can be done. CONCLUSION: This case shows the inclusion of LPD in the differential diagnosis of peritoneal masses is of paramount importance, especially in women of childbearing age. Early and accurate diagnosis will help in avoiding the unnecessary aggressive measures.