Abstract: Lipomas are benign mesenchymal tumour. Thirteen percent of lipomas are seen in head and neck region1. Anterior neck lipoma is a rare one & anterior neck lipoma with mediastinal extension is extremely rare. We are reporting a case of 48 yr. old female who presented with a huge swelling in the anterior neck region simulating a goitre. It was one of the largest of its own kind. FNAC & sonography helps in making early diagnosis of lipoma apart from clinical examination. Enucleation of lipoma from neck as well as mediastinum was done & followed up for 1 year without any complication.