Objective: To investigate the clinical and pathological features, diagnosis, differential diagnosis, treatment and prognosis of superficial leiomyosarcoma (SLMS). Methods: We retrospectively analyzed the clinicopathological features of 13 cases of SLMS, and reviewed the related literature. Results: Seven male cases and 6 female cases were collected, the average age of all patients was 59 years old. Tumor lesions were located in the extremities (7 cases), trunk (3 cases), head and face (2 cases) and scrotum (1 cases) respectively, and 9 cases of them were located in the dermis, and 4 cases were under the skin. The average diameter of all tumors was 1–8 cm, with an average of 4.3 cm. Local recurrences were investigated in 5 cases, and no distant metastasis was found. Microscopic observation revealed that the tumors were nodular or diffuse, of which, 9 cases of moderately differentiated tumor cells, 2 cases of high differentiated and 2 cases of low differentiated tumor cells were observed. Immunohistochemical staining showed that desmin, MSA, h-caldesmon and a-SMA were positive in these tumor cells. Conclusion: Superficial leiomyosarcoma often occurs in the elderly. The prognosis of SLMS is good. The local recurrence rate of SLMS was high, but there was almost no distant metastasis.