Lipomas are rare benign tumors in the larynx. We encountered a 70-year-old man with a large lipoma in the subglottic area. His chief symptom was a 3-month history of progressive dyspnea. Transnasal flexible endoscopy showed a large mass on the posterior wall of the subglottic region. A computed tomography scan revealed a lesion occupying 75% to 80% of the subglottic airway. In this article, we discuss the imaging changes, clinical evaluation, and treatment of this patient’s lipoma.