Leiomyosarcoma is a mesodermal malignant neoplasm affecting the small intestine. Usually, the clinical signs are not specific and most commonly related to intestinal bleeding or obstruction. We report the case of a 71-year-old woman presenting anemia and melena: there was no evidence of abdominal palpable mass and endoscopic examinations were negative for pathologic findings. We performed sonography and CT-enterclysis. We detected a small jejunal mass presenting a heterogeneous density and echogenicity pattern, with some large peripheral calcifications. Histologic examination after surgery revealed the lesion to be a small bowel leiomyosarcoma.