Vascular leiomyomas (VL) are benign lesions of perivascular origin. We report two new cases and discuss their clinical, histological and immunohistochemical characteristics, in order to facilitate the diagnosis and treatment of such lesions. The patients, both male, presented asymptomatic nodules located in the bottom of the labial sulcus and buccal mucosa. In the second case, color doppler ultrasonography was performed, which showed no change in blood flow. After excisional biopsies, a limited lesion was observed histologically, with multiple tortuous vessels of varying sizes and calibers, and among them, spindle cells bundles, positive for smooth muscle actin. Oral VLs have clinical features similar to those of other more common lesions, making preoperative diagnosis difficult. Imaging examination, such as color doppler ultrasonography, may help in diagnosis. In general, excisional biopsy is performed, due to the ease of removal of the lesion during surgery. The treatment of choice is the complete excision of the lesion, which has an excellent prognosis and a low rate of recurrence.