Introduction <p>Disseminated Peritoneal Leiomyomatosis (DPL) is a rare benign condition characterized by the proliferation of solid peritoneal lesions within the abdominopelvic cavity, composed of smooth muscle and connective tissue. Although hormonal and iatrogenic factors have been suggested as potential causes, the exact etiology remains unknown. DPL is commonly observed in premenopausal patients, particularly those with a history of myomectomy or hysterectomy. Patients may either remain asymptomatic or present with symptoms such as abnormal uterine bleeding and abdominal discomfort. Radiological investigations play a crucial role in distinguishing DPL from malignant peritoneal disease. Treatment options vary based on the patient’s age, fertility status, and clinical presentation encompassing both medical and surgical approaches.</p> Case presentation <p>We present a case of a previously healthy female who experienced abdominal discomfort and bloating and pressure symptoms of bladder. An MRI revealed multiple leiomyomas. Intraoperatively, numerous peritoneal nodules were incidentally discovered. Histopathological examination confirmed the diagnosis of disseminated peritoneal leiomyomatosis.</p> Clinical discussion <p>Distinguishing DPL from conditions such as leiomyosarcoma, endometriosis, and peritoneal carcinomatosis remains challenging due to their similar macroscopic appearance. Therefore, histological evaluation is essential for an accurate diagnosis.</p> Conclusion <p>Recognizing DPL is vital to prevent misdiagnosis and the unnecessary anxiety associated with a presumed malignancy. Despite its worrisome presentation, DPL is generally a benign condition.</p>