Gastric leiomyoma is an uncommonly found entity. Most leiomyomas are asymptomatic and are found at autopsy or on abdominal exploration for other reasons. Indications for resection include large size and symptoms of compression, obstruction, or hemorrhage. The traditional surgical approach consists of laparotomy and resection. This article describes a technique for minimally invasive resection using a combined laparoscopic and endoscopic approach.