Leiomyosarcoma is the rare malignant tumor of smooth muscle. The primary leiomyosarcoma of the skin is known to be less aggressive and have better prognosis than leiomyosarcoma of other organs. Because of the difference in treatment and prognosis, differentiating metastatic cutaneous leiomyosarcoma from primary cutaneous leiomyosarcoma is important in clinical setting. Herein, we introduce a case of middle-aged man visited our outpatient clinic complaining of solitary erythematous solid nodule on the scalp. The nodule was finally diagnosed as metastatic cutaneous leiomyosarcoma based on the medical history and skin biopsy. Scalp is the location that both primary and metastatic cutaneous leiomyosarcoma is commonly found. In addition, the detection of the metastatic scalp leiomyosarcoma sometimes precedes the diagnosis of the primary leiomyosarcoma. Therefore, when the leiomyosarcoma of scalp is diagnosed, careful diagnosis considering both clinical and pathological information should be made whether the lesion is primary or metastatic.