Objective: To investigate the clinical features and prognostic factors of pulmonary metastatic leiomyoma (PBML). Methods: The clinical data of PBML cases reported in PubMed, CNKI and Wanfang database from January 1957 to December 2020 were retrieved and collected. Combined with the diagnosis and treatment process of 1 PBML patient admitted to the Second Affiliated Hospital of Hainan Medical College, the risk factors and prognosis were analyzed by χ² test and Fisher’s accurate test. Results: A total of 151 PBML patients, all female, aged 46.10±7.05 years, including 147 patients with previous uterine fibroids, often due to chest CT physical examination found multiple nodules in both lungs, pathological HE staining showed spindle tumor cells, immunohistochemistry showed positive expression of ER and PR, negative or low expression of Ki-67. Correlation analysis showed that there were no significant differences in age, time between onset, nodule size, expressions of ER and PR, treatment plan and prognosis (all P<0.05). Conclusion: PBML is extremely rare, it is more common in women of reproductive age with a history of uterine fibroids, it does not show specific clinical symptoms, the disease has a better prognosis and a long survival period. However, the time of lung metastasis, age, nodule size, immunological expression and treatment options did not show a significant impact on the prognosis, the related factors of the prognosis still need to be further explored.