Clinical features of vascular leiomyoma of the upper extremity which have not been described or have been described incorrectly are documented with a report of 11 consecutive cases seen within the past 11 years. All patients were followed without recurrence or surgical morbidity. Vascular leiomyoma has been described as a painful nodule found more frequently on the extensor surfaces, but in our experience spontaneous or paroxysmal pain is exceptional and the tumour tends to be located on the volar surface when it is in the hand. In the digit, they tend to be found at the base away from the midline, and not seen distal to the DIP joint.