Floating fat is a sign of acute bone injury at the knee following trauma. The goal of this article is to review the etiology, patterns, and mimickers of extra-capsular and intra-capsular floating fat, with the major emphasis on knee trauma in the acute setting. We will discuss the spectrum of multimodal imaging findings for rare presentations of extra-capsular floating fat, and contrast these with common and atypical forms of intra-capsular lipohemarthrosis, as an aid to the assessment of acute bone trauma at the knee.