Uterine leiomyosarcoma constitutes one of the rare gynecological cancers and contributes to less than 1% of female genital tract cancers. Being one of the rare sites for metastasis development, metastasis of uterine neoplasms in the nasopharyngeal region is extremely rare. A 53-year-old multiparous woman with FIGO Stage Ib uterine leiomyosarcoma presented with nasal congestion 1 year following primary treatment. Paranasal computed tomography revealed a nasopharyngeal mass. The immunohistochemical study demonstrated that tumor cells were stained negative for desmin, h-caldesmon, and estrogen receptor, and were positive for p16 and Ki67. The proliferative index was 50 to 60%, confirming the nasopharyngeal metastasis of uterine leiomyosarcoma. No distant metastasis or local recurrence was evident in her systemic radiological evaluation. The patient received curative radiotherapy after nasopharyngeal mass excision, following which systemic chemotherapy was initiated. After the completion of treatment, the patient was followed for 9 months without recurrence or metastasis. These findings demonstrated that local treatments for metastases will contribute to patient survival.