Objective： To explore the clinical characteristics of leiomyosarcoma（LMS） and the factors influencing prognosis. Methods： The clinical data of 27 patients with LMS were retrospectively analyzed and summarized， including clinical features， pathological type， curative effect and prognosis. Results： The patients with LMS were most aged between 40 to 60 years old. The main symptom of LMS was irregular menses（29.6％）， followed by climacteric irregular colporrhagia（18.5％）， celialgia（18.5％） and bythus lump（11.1％）. The diagnosis rate before operation and during operation was 25.9%; 17 cases were misdiagnosed as hysteromyoma or uterus adenomyosis， 3 cases were misdiagnosised as tumor of the ovary， and the misdiagnosis rate was 74.1%. Eight cases at stageⅠwere treated by surgery simply, and 19 cases at stageⅡ，Ⅲ and Ⅳ were treated by surgery combined with chemotherapy. The 5-year survival rate of the patients at stageⅠwas 87.5%. The average 5-year survival rate of patients behind stageⅡwas 42.1％. The 5-year survival rate of patients at stageⅡ， Ⅲand Ⅳ was 70.0％， 20.0%， 0%，respectively. Conclusion： LMS could be easily misdiagnosed. It was fairly difficult to make an early diagnosis. The main treatment method of LMS was surgery. The prognosis of LMS is obviously related with age and clinical staging. To reduce recurrent and to increase survival rate， it is important to confirm the diagnosis before or during operation and combine with adjunctive therapy after surgery.