Tumors from the vessel walls are rare. Leiomyosarcoma from the Iliac vein wall can present as mass, deep vein thrombosis. Complete excision is the best possible treatment for them. Reconstruction of the resected is to be considered if possible. Usually these grafts may get thrombosed after some time without any problems due to the development of collateral veins. Prognosis is poor if there are metastasis to the liver and lung. Their 5 yr survival is reported to 32%. Till now less than 100 cases of leiomyosarcoma were reported from extremity veins.