Leiomyoma is a benign smooth muscle neoplasm most commonly found in the uterus and gastrointestinal tract. Cutaneous leiomyomas are rare and are distinguished based on their proposed cell origin, with genital-type being an uncommon subset. Leiomyomas of the nipple-areolar complex are the least common of this subset and thought to arise from the dartoic muscle of the nipple. A review of the literature identified fewer than 50 reported cases of leiomyoma of the nipple. These tumours are most commonly seen in middle aged women, with an approximate 3:1 female to male predominance. We present a rare case of leiomyoma of the male nipple.