Benign symmetric lipomatosis (BSL) is a rare disease of unknown etiology, characterized by symmetrical fatty deposits on the suboccipital area, neck, shoulders, upper arms and upper parts of the trunk. The disorder predominantly affects male alcoholics between the ages of 30 and 60 years. The incidence is highest among residents of Mediterranean countries. It is very rare disease in oriental countries. We report a case of a benign symmetric lipomatosis mimicking thyroid tumors. 65-year-old man with past history of alcoholism, presented with slowly enlarging mass on anterior neck and posterior neck since 2011. He had no respiratory or gastrointestinal symptom other than palpable neck mass and cosmetic problem. Thyroid function test and all laboratory finding including anti-thyroid antibody were within normal limits except for mild elevated aspartate-amino transferase. Neck ultrasonography showed diffuse goiter with heterogeneous echogenicity and well de. ned, mild echogenic mass mimicking thyroid tumors on the left thyroid lobe. Ultrasound guided fine needle aspiration (FNA) of the thyroid nodule was performed. However, FNA cytology revealed insufficient result. A computed tomography detected a small thyroid gland and diffuse subcutaneous fat in. ltration in the anterior neck and occipital region. He underwent surgical excision of neck mass for diagnosis and cosmetics. In view of the past history, clinical presentation, radiographic, and histologic finding, a diagnosis of benign symmetric lipomatosis was made.