A 44 year old woman presented with atypical chest pain. Investigation revealed a mass lesion in her posterior mediastinum. Its extraliminal location in the esophagus was confirmed by esophagoscopy and its origin from the muscular layer of the esophagus was demonstrated by esophageal ultrasound. This leiomyoma was excised at thoracoscopy and this expedited the patient's postoperative hospital course.