Non Rhabdomyosarcoma Soft Tissue Sarcomas (NRSTS) are rare in the pediatric age group, accounting for 1-7% of all pediatric tumors. Leiomyosarcoma, a subtype of NRSTS, is exceedingly rare in pediatric population. Due to the rarity of this condition, management is extrapolated from other common NRSTS which involves surgery, chemotherapy and radiation. Chemotherapy is not very effective in management of pediatric leiomyosarcoma and molecular information may help guide targeted therapies. We describe a patient with a FGFR1-TACC1 gene rearrangement which, based on other models, predicts for sensitivity to FGFR inhibitors.