Background Posterior choroidal leiomyoma is an extremely rare tumor, to our knowledge, less than 10 cases reported in the literature. The definite diagnosis can be confirmed by immunohistochemistry, and local resection is preferable to enucleation for the posterior choroidal leiomyoma. Case presentation Two adult Asian women presented with progressive vision loss in their right eyes. Ophthalmic examination revealed an amelanotic dome-shaped choroidal mass located in the fundus with yellowish exudative retinal detachment. Clinical differential diagnosis of a nonpigmented choroidal neoplasm mainly includes amelanotic melanoma, atypical hemangioma, metastatic carcinoma, as well as the rare posterior choroidal leiomyoma. Considering the choroidal lesion was more likely to be a benign tumor, then we performed the treatment of local resection by pars plana vitrectomy and the histopathological examination confirmed the diagnosis of choroidal leiomyoma. The best corrected visual acuity of the patients was more than 20/100 on 6-month follow-up. Conclusions From these two posterior choroidal neoplasm cases, we were able to demonstrate local resection by the 23 to 25-gauge mircoinvasive vitrectomy for excision of intraocular tumors is a feasible treatment for choroidal leiomyoma.