Introduction: Lipomas are the most common benign mesenchymal tumors, which account for almost 50% of all soft-tissue tumors.
Case outline: The case of a 75-year-old patient with a slow growing lesion of para- and retropharyngeal space was reported. The patient was suffering from progressive dysphagia, respiratory obstruction and sleep apnea.
Conclusion: An external surgical approach is the treatment of choice. Etiology, differential diagnosis and therapy of head and neck lipomas has been discussed.