Cutaneous pilar leiomyomas are benign, often painful, smooth muscle tumors that usually present as red-brown nodules. They are usually multiple and commonly found on the extensor aspects of the arm, trunk, and face. Multiple lesions may be grouped or widespread. They are rarely distributed in a linear fashion or seem to follow a dermatome. We report a 54-year-old woman with multiple pilar cutaneous leiomyomas distributed in a zosteriform pattern on her right trunk.