Angioleiomyoma (ALM) is a rare benign, vascular smooth muscle tumor originating from the tunica media of the vessel wall. It typically arises in the cutaneous, subcutaneous tissue of the lower extremities in middle-aged women. In this article, the author will review the characteristic vascular status of subtype of ALM on color and power Doppler US along with magnetic resonance imaging (MRI) appearances. Given the occurrence location, close to or in contact with dermis, it is strongly suggested that angioleiomyoma may contain vessel components in the tumor. It is plausible that estimations of vascular pattern, density, distribution, and spectral Doppler analysis on high-resolution ultrasonography (US) contribute to make an accurate diagnosis of the subtype of ALM. In solid (or capillary) subtype, little vascularity and adjacent vascular features on color and power Doppler US and enhancing structures on one or both ends of the mass on MRI may be the potential diagnostic findings.