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This systematic review examines sinonasal leiomyomas, which are rare benign smooth muscle tumors in the nasal cavity and paranasal sinuses. The review summarizes the clinical and pathological tumor characteristics, surgical management, and follow-up of 84 patients across 40 studies. The tumor was most commonly located in the nasal cavity, originating from the inferior turbinate, and patients presented with symptoms including recurrent epistaxis, nasal obstruction, and localized facial or head pain. Surgery was performed in all cases, with an endoscopic approach most frequently chosen. Recurrence occurred only twice, and morbidity was noted in 2 cases following postoperative bleeding and 1 case following a CSF leak. The goal of management is total resection with clear margins to avoid local recurrence.
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