Benign symmetric lipomatosis (Madelung disease) is a rare disorder of unknown etiology characterized by diffuse growth of unencapsulated lipomas predominantly in the head, neck and shoulder region. Involvement of the tongue has been previously described in only five cases. A 49-year-old man with alcoholic liver cirrhosis presented with an 11-year history of benign symmetric lipomatosis complaining of increasing dysphagia, dysarthria and hoarseness. Clinical intraoral examination revealed asymmetric, globular, firm, circumscribed masses on both borders of the tongue. During surgery, the masses seemed encapsulated from surrounding muscles and could easily be extirpated. However, "satellite fat cells" became obvious, which might give rise to the development of new lipomas.