Cutaneous leiomyoma is a benign tumor of smooth-muscle fibers. There are five types of cutaneous leiomyoma; multiple piloleiomyomas; solitary piloleiomyoma; solitary genital leiomyoma; solitary angioleiomyoma; and leiomyoma with additional mesenchymal elements. A 50-year-old woman had a 13-year history of variable sized painful eryhtematous papules and nodules on the left upper chest, shoulder, arm and back. These lesions were distributed in a zosteriform pattern and corresponded with the left fourth cervical and the left second thoracic dermatome. The histopathologic findings revealed typical piloleiomyoma. One case of zosteriform cutaneous leiomyoma has been reported in the Korean literature. However, the lesions of the case corresponded with two close dermatomes and developed widely. Such a case has never been reported in the Korean literature case. (Korean J Dermatol 2008; 46(7):965∼968)