Mediastinal angiolipoma is a rare benign neoplasm composed of mature adipose tissue with an abnormal vessel. Owing to its unspecific symptoms and slow progressions, the diagnosis of this disease is often delayed by clinicians. Here we present a 68-years-old-woman presented with mild chest pain radiates to the back with chronic dry cough. Chest imaging showed right medial posterior intrathoracic mass attached to 3rd-5th vertebrae body without bone destructions. Exploratory thoracotomy with segmentectomy was successfully performed. Histopathology examinations showed adipose tissue surrounded by a blood vessel nest, typical for angiolipoma. The patient showed rapid recovery and was discharged a week after the surgery. After two years of follow-up, the patient showed no sign of tumor recurrence and was clinically stable. This case is the first occurrence of non-infiltrating mediastinal angiolipoma reported in Southeast Asia.