Abstract Lipomas are non-cancerous growths consisting of mature fat cells. Lipomas usually manifest as distinct, pliable lumps in the fatty tissues beneath the skin. Around thirteen percent of lipomas are observed in the head and neck area. An anterior neck lipoma is quite uncommon, and an anterior neck lipoma extending into the mediastinum is an exceedingly rare occurrence. Here, we present a case of 50 years old female who came with a huge swelling in anterior neck region (prevertebral space) which was slow growing. The purpose of this report is to keep in mind the differential diagnosis of lipoma when patient presents with anterior neck soft tissue swelling. Keywords: Lipoma; Anterior neck; Prevertebral space Introduction A lipoma is a non-cancerous growth formed from mature fat cells and is sometimes referred to as the “universal tumor” or the “widespread tumor” because it can develop in any part of the body where fat cells accumulate. In the head and neck region, lipomas account for approximately thirteen percent of cases [1]. While lipomas in the neck typically manifest in the posterior triangle area, those found in the front part of the neck (anterior neck lipomas) are infrequently encountered. Moreover, giant anterior neck lipomas, which measure over 10 cm in size, are exceptionally rare [2]. In this report, we present a case of such giant anterior neck lipoma with retrosternal extension.