This report presents a rare case of angioleiomyoma originating from the radial artery. A 42-year-old female presented with a pulsatile and painful mass in the right wrist. The patient was diagnosed as a pseudoaneurysm based on physical findings and contrast-enhanced CT findings, and surgery was performed. However, postoperative pathological examination revealed angioleiomyoma. Angioleiomyoma is a relatively rare, benign, vascular soft tumor originating the tunica media of a blood vessel. The tumor tends to occur in the lower extremities and rarely in the upper extremities. The definitive diagnosis by image inspection is difficult before surgery and most cases were diagnosed by postoperative histopathological examination. This mass may present with localized pain. Therefore angioleiomyoma should be considered in a patient presenting with a painful small tumor along a blood vessel.