Background Lipomas are the most frequent soft tissue tumour in humans, accounting for approximately 16% of all mesenchymal tumours and whilst most often found in the upper body, only 1% are found in the hand. They usually present as asymptomatic, soft, non-fixed masses, if large enough can reduce motion and cause pain. Given lipomas of the finger are exceptionally rare, they are often not considered in the differential diagnosis of finger masses. Methodology Following an extensive literature review (PubMed and Ovid from inception to December 2023) we were able to identify a total of 36 cases of finger lipoma in the literature. Whilst most occurred in patients aged 50-70 years; there was no obvious predilection for gender, handedness or finger affected. In all reports the lipoma occurred either volar or dorsal. Nil reports of recurrence after surgical excision exist. Case report We present the case of a right hand dominant 71yo male with a 10-year history of soft lump of the left ring finger, which was near circumferential and involved the entire length of the middle phalanx. Range of motion was significantly reduced, and he reported radial sided tip paraesthesia. Xray was unremarkable for bony changes and ultrasound was suggestive of lipoma. He underwent surgical excision of the lump, without complication, and histopathology confirmed a 42x38x12mm simple lipoma. Pain resolved, range of motion improved and there was no evidence of recurrence on follow-up. Conclusion Lipomas of the finger are rare, and surgical excision appears to be an effective treatment choice for those which are symptomatic. Despite their rarity, surgeons should consider lipoma as a differential diagnosis when treating the patient with a finger lump.