Lipomas are the most common benign mesenchymal tumors in adults. Generally, they are less than 5 cm in size but sometimes they can present as giant lipomas. Axillary region is an unusual localization for lipomas in general, especially for giant lipomas.A case of a 62-year-old male with a giant lipoma in the axillary region is presented. The tumor was located in the left axillary region beneath the pectoralis major muscle and extended all along to the scapula. It was adjacent to the axillary vessels and the brachial plexus, but did not invade the neurovascular bundle. A team of a plastic and thoracic surgeon performed the operation. The pathology report confirmed a benign lipoma weighting 454 grams and measuring 13.5x8x7 cm. Follow-up examinations (clinical examination and ultrasound) revealed no recurrence three years after the operation.The mechanism of lipoma formation is not completely clear. It includes two potential and overlapping mechanisms in which trauma seem to have the major role. The treatment includes surgical excision or liposuction. However, excision of large lipomas can sometimes be a surgical challenge.Giant lipomas in axillary region should be removed in order to establish the pathohistological diagnosis and to prevent possible compression of the neurovascular structures. In our opinion, surgical excision is a preferred method of treatment because there is less possibility of damaging vital structures and it offers better control against local tumor recurrence.