Madelung``s disease, known as multiple symmetric lipomatosis (MSL) is a rare disease characterized with multiple, symmetric, loose adipose tissues distributed around the neck, shoulder, back or chest. MSL is different from simple obesity, which is characterized by the presence of well-distributed total body fat. Typically, most of the patients with MSL are middle-aged men with excessive alcohol intake and it has been rarely reported in Asia. Herein, we experienced an uncommon case of MSL clinically shown characteristic features. Two middle-aged women presented prominent fatty deposition on posterior neck, shoulder, abdomen, back and both arms were referred to our clinics. Clinically, they showed a washboard appearance on the back. Both of them confessed a history of chronic alcohol abuse. The diagnosis was made on the basis of the history, clinical appearance, histopathologic and MRI findings. Among the previously reported cases, our case is the only case emphasizing the association between MSL and alcoholism in Korean dermatologic literature. It is worthy not only it arouses our careful attention to take alcohol but also suggests clinical clue for diagnosis.