Lipoma is a common benign tumor of soft tissues but rarely located in the hand or being responsible for neuropathy. A case of compressive lipoma of the Guyon canal with purely sensory disorders has been evolving for 04 years in a 56-year-old woman. The mass was removed without any damage to vascular, neural, or tendinous structures. Postoperative recovery was straightforward, and the patient regained good mobility in the hand and fingers.