Benign symmetrical lipomatosis, known as Madelung's disease, is characterized by non-encapsulated fat tissue accumulation in a symmetrical, progressive manner around the neck, shoulders, and upper extremities. To date, there have been approximately 200 cases reported. We experienced one cases of Madelung's disease, accompanying dyspnea. The fat tissues were surgically excised by external approach. We report it with a review of the current literatures.