Intraosseous lipoma is a rare, benign primary tumor occurring in the bone. It typically occurs in long bones, such as the femur, tibia, and fiblua. While irregular bone and flat bones occur very rarely. Patients with intraosseous lipomas are asymptomatic in the early stages, but symptoms may appear in the later stages, accompanied by complications such as pain and fracture. On the X-ray plain, an intraosseous lipoma presents as an osteolytic lesion with well-circumscribed, and accompanied with a sclerotic margin and unevenly calcified parts. Recurrence and malignant transformation of intraosseous lipoma are extremely rare, and usually not requiring surgery. The possibility of malignant transformation and recurrence may be low, and usually not requiring surgery. In this article, we report a case of intraosseous calcaneal lipoma complicated with pathological fractures that was treated by curettage of the lesion and bone grafting , and local plate osteosyntheses showed good results. Combining this case with similar cases at home and aboard and reviewing related literature, we formed conclusions based on the manifestations, diagnosis, treatment, and prognosis of this disease and provided treatments and a new idea for the study of similar cases.