Endobronchial lipoma is a very rare benign tumor. The most frequent clinical presentation is caused by airway obstruction. A computed tomography finding of a homogeneous mass with fat density not enhanced by intravenous contrast material is considered diagnostic of this kind of tumor. The definitive diagnosis is given by bronchoscopy and biopsy. The treatment of choice is endoscopic resection, although open resection is sometimes required. We present a case of endobronchial lipoma that involved the left main bronchus and extended through the bronchial carina. Endoscopic treatment was initially attempted. However, open resection through superior lobectomy with carinal resection and a bronchoplastic procedure were required to avoid left pneumonectomy.