This study expands the clinicopathological features of COL1A1–PDGFB fusion uterine sarcomas of the cervix, adding the first Chinese case to the five reported cases and highlighting a potential pitfall in the morphological differential diagnosis with NTRK fusion uterine sarcoma, leiomyoma, LMS, HGESS, and undifferentiated uterine sarcoma. The gene discussed is COL1A1; the disease is leiomyoma.