Lipomas are very common benign soft tissue neoplasms arising from fatty tissue and may occur anywhere in the body. They are usually slow growing, painless masses often noted in the extremities of adult women. Occurrence in the hands and feet is unusual and those found in the digits are extremely rare. We describe a case of a lipoma presenting as a soft tissue mass of the index finger and show how computed tomography was extremely helpful in preoperative assessment by accurately defining the size of the lesion, the degree of bone involvement, and even giving indication of its underlying pathology.