Lipomas are common benign neoplasms consisting of mature fatty tissue. They are usually of roundish or ovoid shape and are situated in a single anatomical region. They most frequently occur on the back and in the extremities. We present a rare case of a giant hourglass-shaped lipoma displacing the axillary neuro-vascular bundle, extending between the heads of the biceps brachii muscle, and distending the deltoid muscle. The lipoma was excised through a deltoidopectoral approach with uneventful healing. The radiological and MRI findings and surgical challenges are briefly discussed.