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Ovarian leiomyosarcoma is a rare and aggressive cancer that arises from smooth muscles of ovary. Incidence of this cancer is 0.1% in a Million. We presenting a case report of 60-year-old post hysterectomized female who admitted with abdominal pain and diarrhoea since one month and having a history of Type 2 Diabetes Mellitus since 10 years. Radiological examination has revealed a large pelvic-abdominal mass measuring approximately 12 × 16.3 × 16 cm, originating from the left ovary. Surgical excision of a large complex ovarian mass was performed, a detailed histopathological and immunohistochemical analyses confirming the diagnosis of leiomyosarcoma. The report discusses the clinical presentation, diagnostic process, treatment strategy, and postoperative outcome, emphasizing the rarity and diagnostic challenges of this aggressive ovarian malignancy.