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BACKGROUND Disseminated peritoneal leiomyomatosis (DPL), or leiomyomatosis peritoneal disseminata, is a benign condition that presents with multiple lower abdominal peritoneal nodules consisting of smooth muscle cells, which can slowly increase in size. The risk of malignant transformation is 2% to 5%. The mechanisms underlying the pathogenesis and malignancy of DPL are unclear and can be associated with a variety of factors. This report describes a 59-year-old woman presenting with multiple abdominal masses and a diagnosis of DPL. CASE REPORT This report describes a 59-year-old female patient who experienced abdominal pain and difficulty defecating. Proctoscopy showed intestinal stenosis and inflammatory changes. She may have had renal dysfunction. The medical history showed that the patient had uterine fibroids in the past and had undergone hysterectomy surgery. We cannot confirm whether the patient received hormone therapy before admission. Based on the results of histopathology and immunohistochemistry, it was considered to be a DPL. The patient died 6 months after surgery. CONCLUSIONS DPL is a rare disease that is difficult to diagnose and traditionally considered a benign condition. This report emphasizes the importance of understanding the presentation and distribution of DPL, as it can mimic the deposition of malignant tumors. This case also emphasizes the importance of diagnosing benign tumors through histopathology. The mechanism of malignant transformation of DPL is currently unclear, and it is of great significance to combine multiple detection methods in clinical practice to determine its malignancy.