Multiple benign symmetrical lipomatosis (Madelung’s disease, Launois-Bensaude syndrome) is a rare disease with multiple symmetrical unencapsulated fatty accumulation diffusely involving the neck, shoulders and upper trunk. That abnormal deposits of adipose tissue has unknown ethiology. Due to its progressive behaviour and localization this disease has not only cosmetic but also functional consequences. We report a case of 50-year-old man with a Madelung's disease in whom progressive fatty tissue accumulation caused an inspiratory dyspnea and aesthetic deformities of neck, shoulders and upper extremities. The ethiopathogenesis, types, diagnostic and therapeutic aspects of this rare disease are discussed.