Introduction: This was a unique case of solid subtype angioleiomyoma located in the right posterior neck triangle of a 12-year-old boy, emphasizing the differential diagnoses and the diagnostic journey. Objective: This report aimed to study the importance of differential diagnosis of pediatric neck lumps. Methods: Clinical examination, imaging (ultrasound and CT scan), and histological evaluations were employed. Results: Despite initial assumptions surrounding the nature of the lump, histological examination following an excisional biopsy confirmed it as a solid subtype angioleiomyoma. Conclusion: The report stressed on the importance of including angioleiomyoma in the differential diagnosis for pediatric neck lumps and the significance of histological examination in achieving a definitive diagnosis.