Madelung's disease, also known as benign symmetric lipomatosis, multiple symmetrical lipomatosis or Lanois-Bensaude syndrome, consists of growth of fatty masses predominantly on the face, neck, shoulders, upper thorax and arms. These painless and symmetrical fatty deposits can cause important aesthetic changes in these patients. Middle-aged males are more commonly affected, with an increased prevalence in the Mediterranean area. Currently, the incidence in Italy is 1 in 25,000 males. The aetiology of Madelung's disease remains unknown, although approximately = 60% of affected patients are clinically overweight and there is an intimate association with chronic alcohol abuse. We report an unusual case of Madelung's disease in a 52-year-old male. The fatty deposits were completely resected by means of surgical lipectomy. The patient remains well and disease-free after 12 months of postoperative follow-up.