Nineteen deep cervical lipomas and five patients with cervical lipomatosis were examined with computed tomography (CT) and Sonography. By means of CT, which is the imaging method of choice for both diseases, it is possible to differentiate between circumscribed lipomas and infiltrating intramuscular lipomas. In addition, an exact localization in parenchymatous organs is possible. Cervical lipomatosis is also clearly delineated. Sonography is the first imaging method in cervical swelling or lesions; therefore, knowledge of the sonomorphology of fatty tumors is mandatory. Cervical lipomas have a fairly typical sonomorphology, but it is not as pathognomonic as the density values are by means of CT. In cervical lipomatosis, an adequate pretherapeutic assessment of the depth of infiltration is not possible sonographically. Only the cervical vessels can be clearly differentiated in this condition.