Fibrolipomaous hamartoma is a benign neoplasm of nerves, resulting from anomalous growth of fibroadipose tissue of the nerve sheath. The median nerve is the most commonly involved nerve. Magnetic resonance imaging (MRI) features are pathognomonic, showing a coaxial cable-like appearance on axial images and spaghetti-like appearance on coronal images. Preferred management of the lesion is conservative.