Madelung's disease is a rare disease of undetermined cause characterized by symmetric deposits of painless, diffuse, subcutaneous adipose tissue on the suboccipital area, the cheeks, the neck, the shoulders and the upper trunk. It is commonest in countries bordering the Mediterranean. The patients are usually middle-aged male alcoholics. Although lesions can initially mimic a head and neck malignancy, management is essentially symptomatic, with conservative removals done as indicated clinically or for cosmesis. Oriental reports about Madelung's disease are very rare. Here a case of Madelung's disease in a 59-year-old male is described. We describe his clinical course and review the literature.