Objective: Lipomas of the digestive tract are rare benign tumor and most often found incidentally during a colonoscopy, computed tomography scan, surgery or autopsy. Lipomas of the colon were first reported by Bauer in 1757 and are most often located in the ascending colon. The incidence of this lesion is estimated between 0.2 and 4.4 % and represents 1.8 % of the colonic benign lesions. We report a case of patient with symptoms of ileus due to colonic lipoma. Method: A 78-year-old man patient was urgently admitted with symptoms of ileus. Right hemicolectomy was performed, and clinical impression was that it was a malignant tumor. Results: Examination of the cecum we found polypoid whitish yellow tumor, size 4×2,5 cm. On histology the tumor was composed of mature adipose tissue without cellular atypia. The tumor was located into submucosa. Larger parts of the surface mucosa was eroded. The postoperative course was uneventful and intestinal passage was quickly established. Conclusion: Although colonic lipomas seldom cause severe symptoms in patients and are easily removed by endoscope while they are small, severe symptoms like abdominal fullness, intestinal obstruction, intestinal bleeding and intussusceptions may appear as a lipoma grows larger. In some cases lipoma may clinically mimic colonic carcinoma.