We present a case of pancreatic leiomyosarcoma with liver metastasis diagnosed by liver tumor biopsy. A 66-year-old man had a pancreatic tumor and hepatic tumors, which were hypoechoic and mixed echoic on ultrasonography, respectively. They were stained in enhanced computed tomography and angiography. A fine needle aspiration biopsy of the liver tumor was performed, and the pathological examination of the biopsied specimen suggested the tumor cells to have originated from smooth muscle. Under a diagnosis of pancreatic leiomyosarcoma with liver metastasis, the patient was treated with several anticancer agents. The tumor, however, spread to multiple organs and he dies of the disease two years nine months after the start of treatment. The diagnosis of pancreatic leiomyosarcoma was confirmed by autopsy.