A 15-year-old boy developed two, almost symmetric, asymptomatic, depressed plaques, localized to both buttocks after receiving a single intramuscular corticosteroid injection in his right buttock for treatment of lumbar pain. He suffered from asthma since early childhood, and had been repeatedly treated with corticosteroid injections for many years as a young child. A skin biopsy from both lesions was performed, showing a decrease in the number and size of adipocytes. We describe a case of acquired localized lipoatrophy with a particular bilateral distribution secondary to a single intramuscular corticosteroid injection.