Colonic lipomas are infrequent lesions, yet they are the second most common benign lesions of the colon after benign adenomatous polyps. Their treatment ranges from observation to segmental colectomy and has been a matter of debate since Bauer first reported them in 1757. With the advent of new technologies, therapeutic options now include observation, endoscopic removal, laparoscopic removal, and traditional open surgery. We present a case of colonic lipoma presenting with indeterminate symptomatology, its workup, treatment outcome, and a review of the current literature.