Background: Lipoma is a common benign mesenchymal tumor that is typically located in the subcutaneous tissue and rarely symptomatic. Sciatica can be a result of various etiologies but a giant intramuscular pelvic lipoma causing sciatic nerve compression is rare, with not more than 10 cases reported so far in the literature. Case Presentation: We report a case of a 36-year-old female who presented with a complaint of gradually worsening sciatica for 6 months. Magnetic resonance imaging showed a large well-defined intramuscular dumbbell-shaped mass in the right gluteal region, herniating through the sciatic foramen into the pelvis. After successful resection of the mass transabdominally, the histopathological examination confirmed the diagnosis of a benign lipoma. The patient improved gradually thereafter and is asymptomatic since then. Conclusion: Our case not only describes the appropriate diagnosis and surgical management of this common benign entity with a rare location and even rarer clinical presentation but also creates a paradigm for future insight into the effective management of such a patient.

Keywords: Pelvic lipoma, dumbbell shaped, sciatica, intramuscular, liposarcoma.