Intracranial lipoma in the medulla oblongata has been rarely reported. Only two cases have been documented in the literature. This report concerns a patient who complained of nuchal soreness and an unstable gait for 6 months. An olivelike lipoma, arising from the posterior aspect of the medulla oblongata and embedded in the lower cranial nerves, was found at suboccipital craniectomy and posterior laminectomy of C1-2. Partial removal of the lipoma was performed for decompression; radical removal would have been hazardous. The clinical symptoms subsided postoperatively. The computed tomography scan and magnetic resonance image proved useful for properative diagnosis.