Background: Uterine smooth muscle neoplasms are defined as benign or malignant neoplasms composed of cells demonstrating smooth muscle cell differentiation. Uterine leiomyomata, also known as fibroids, are the benign forms and they are the commonest. The main clinical purpose of histopathological classification and staging of uterine neoplasm is to prognosticate on the likelihood for the development of local relapse or metastasis. Aim/objective: To evaluate the adequacy of sampling and reclassify uterine smooth muscle neoplasm diagnosed between 2009-2013 while comparing the findings with cases seen in 2014. Materials and methods: This study was conducted in the department of Anatomic and Molecular pathology, Lagos University Teaching Hospital, Lagos in Southwestern Nigeria. It was descriptive and comparative. Uterine smooth muscle neoplasms diagnosed in LUTH between 2009-2013 were re-examined and described using WHO criteria for the classification of uterine smooth muscle neoplasms. Immunohistochemistry was performed on selected malignant cases. Uterine smooth muscle tumour samples for 2014 were also grossed and examined using standard criteria for handling such specimen and a comparison was made between the two groups.