Madelung’s disease or benign symmetric lipomatosis is uncommon, alcohol abuse is frequently associated. Here, we report a moderate form with bilateral swelling over the supraclavicular fossa, cervical and nuchal areas associated with marked dilation of veins on the skin surface misleading to the diagnosis of superior vena cava syndrome. The final diagnosis was confirmed by CT scan by showing important bilateral unencapsulated fat in the subcutaneous fat of neck, in supraclavicular fossa and beneath the trapezius muscle.