Spindle cell lipoma is characterized by different cell components, mature adiopocytes, spindle cells and collagen bundles, and it presents as a well-defined benign fatty mass on the posterior neck or upper back of middle aged men. As a result of the various ratios of non-adipose tissue, it is difficult to differentiate spindle cell lipoma from liposarcoma. To the best of our knowledge, the imaging features of spindle cell lipoma have not been reported in Korea. We report here on the imaging findings of a histologically confirmed spindle cell lipoma in the subcutaneous layer of the posterior axilla.