Sarcoma botryoides, which usually occurs in the vagina in childhood, is rare in the female reproductive tract of adult women, especially those over the age of 40. We present a case of sarcoma botryoides of the uterine cervix that was an incidental finding in a 46-year-old woman. The tumor formed a grape-like cervical polyp that was locally excised, but rapidly recurred. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The myxoid tumor had a cambium layer and was composed of spindle-shaped myoblastic cells without apparent cross-striations. The tumor cells were immunoreactive for MyoD1 and myogenin. Postoperative chemotherapy (vincristine and actinomycin D) was given according to the Intergroup Rhabdomyosarcoma Study protocol, and the patient was alive without recurrence 45 months postoperatively. This is the only the fourth case reported in detail of a sarcoma botryoides of the uterine cervix in a patient over the age of 40.