AIM: To investigate the ultrasonographic features of ciliary body mesectodermal leiomyomas (CBL).​ METHODS: Ultrasonographic data of 18 eyes from 18 patients with histopathologically confirmed CBL were analyzed, covering the period from March 2018 to February 2024. The study included 5 male and 13 female patients, aged 14-64y, with a mean age of 40.11±13.54y. The following ultrasonographic features were evaluated: tumor base diameter, thickness, maximum base diameter-to-thickness ratio, shape, internal echogenicity, margin echogenicity, internal echo homogeneity, secondary changes, color Doppler flow imaging (CDFI) findings, and contrast-enhanced ultrasound (CEUS) characteristics.​ RESULTS: Conventional ultrasound findings of the 18 CBL cases were as follows: 1) Tumor size: base diameter of (13.48±4.74)×(11.57±4.00) mm2, thickness of 7.70±2.60 mm, and maximum base diameter-to-thickness ratio of 1.77±0.36. 2) Shape: 14 cases (77.8%) were hemispherical, and 4 cases (22.2%) were irregular. 3) Internal echogenicity: the solid component of the tumor was hypoechoic in 16 cases (88.9%) and low-to-medium echogenic in 2 cases (11.1%). 4) Margin echogenicity: relatively hyperechoic with a “ring-shaped” margin in 15 cases (83.3%) and isoechoic in 3 cases (16.7%; compared with internal echogenicity). 5) Internal echo homogeneity: homogeneous in 11 cases (61.1%) and heterogeneous in 7 cases (38.9%), with 6 cases (33.3%) among the 7 heterogeneous cases exhibiting cystic anechoic areas. 6) Secondary retinal detachment was observed in 4 cases (22.2%). CDFI revealed heterogeneous vascularity within the tumors, with blood flow signals ranging from minimal to marked. CEUS was performed in 14 patients: complete contrast agent perfusion was observed in 10 cases (71.4%), and partial perfusion was noted in 4 cases (28.6%). Additionally, 8 cases (57.1%) showed a rapid wash-in and slow wash-out pattern, while 6 cases (42.9%) demonstrated a rapid wash-in and rapid wash-out pattern. CONCLUSION: CBL exhibit relatively typical ultrasonographic features, which can provide valuable evidence for the clinical diagnosis and differential diagnosis of intraocular tumors.​