Adrenal leiomyomas are rare, benign tumors originating in the adrenal glands. They have a varied age of presentation, occur with a slight female predominance, and are typically unilateral, although bilateral cases can occur. Symptoms typically include abdominal or flank pain. This report presents a rare case of an 11-year-old male with disseminated molluscum contagiosum, diagnosed with bilateral adrenal leiomyomas. Imaging revealed large, heterogeneous adrenal masses, and the patient underwent successful adrenalectomy. This case underscores the rarity of adrenal leiomyomas in the pediatric population and highlights the critical role of imaging and surgical intervention in their management.