Ataxia telangiectasia (A–T) is a primary immunodeficiency disorder characterized by recurrent sinopulmonary infections, oculocutaneous telangiectasia, progressive neurodegeneration and cerebellar ataxia. It is an autosomal recessive disorder. Patients with A–T have an increased risk of malignancies including heterozygous carriers who may otherwise be phenotypically normal. Benign tumors such as leiomyoma has also been reported rarely in A–T patients. We report a young child with A–T who was followed up as combined immunodeficiency, subsequently developed ataxia, telangiectasia and later developed leiomyoma of the liver, a hitherto unreported malignancy in A–T.