Abstract: Objective: To discuss the MSCT features of central airway primary leiomyoma and improve the diagnostic ability of this disease. Methods: The MSCT findings, clinical characteristics and pathological findings of 7 patients with pathologically confirmed central airway leiomyoma were retrospectively analyzed. Results: 1 male and 6 females with age of 19-65 years old were included, all with nonspecific respiratory symptoms. There were 2 cases located in trachea, 1 case in carina, 3 cases in left main bronchus and 1 case in right main bronchus, with maximum diameter of 0.6-2 cm. MSCT showed the shape of tumors were round or oval in 6 cases and lobular in one case. 6 cases were entophytic growth type and 1 case was both entophytic and helophytic growth type. 7 cases of patients CT scan without contrast showed homogeneous density with no calcification or fat. Enhanced CT scan showed 6 cases with moderate to marked enhancement and 1 case with mild enhancement. No necrosis or cystic degeneration were observed in 7 cases, no meditational adenopathy or pleural effusion either. There were 2 cases with obstructive change. Conclusion: There are some features of central airway leiomyoma on MZCT such as regular tumor in the lumen, often demonstrate marked enhancement. CT and post processing techniques have a certain value in showing size, range and the relationship with adjacent structures of the tumor.