Urethral leiomyomas are rare begin mesenchymal tumors that arise from the smooth muscle of the urethra. Most reported cases in the literature have occurred in women of child bearing age. These tumors present with a variety of symptoms. Excision is curative however occasional cases of relapse have been described. Here we describe a case of a female teenager who presented with intermittent urinary retention and final histopathological diagnosis of leiomyoma of the distal urethra following excision. She had an uneventful recovery and has remained completely symptom-free. To the best of our knowledge, this is first case of urethral leiomyoma in Pakistan that has presented with a history of recurrent urinary retention.