BACKGROUND We examined the expression of estrogen and progesterone receptors in patients with uterine leiomyosarcoma (LMS) to determine their influence on prognosis (overall survival and disease-free survival) and to evaluate the association between the steroid receptor expression and various clinicopathological parameters. METHODS Estrogen and progesterone receptor expression was investigated by immunohistochemistry from paraffin-embedded tissue in 21 patients with uterine LMS. The immunohistochemical findings were correlated with different clinicopathological parameters of the patients. RESULTS Estrogen and progesterone receptors were expressed in 57% and 43%, respectively. The relationship between estrogen and progesterone receptor expression and clinical stage, age, vascular space involvement and recurrence of disease did not reach statistical significance (p > 0.05). Neither estrogen nor progesterone receptor expression significantly influenced overall survival and disease-free survival (p > 0.05). Early tumor stage (p = 0.0001), age at diagnosis < 50 years (p = 0.02) and the absence of vascular space involvement (p = 0.04) were prognostic factors associated with a lengthened overall survival. CONCLUSIONS In conclusion, the present study observed that estrogen and progesterone receptors are frequently expressed in uterine leiomyosarcoma. However, their expression did not correlate with clinical stage, age, vascular space involvement and recurrence of disease and had no influence on overall and disease-free survival. Despite the lack of prognostic impact, further clinical studies with larger numbers of cases need to be performed to verify if estrogen and progesterone receptor-positive tumors can be treated by hormonal manipulation.