We present a case of an abdominal cavity myolipoma which herniated through a low transverse abdominal (Pfannenstiel) incision, and presented as an enlarging abdominal wall mass. Magnetic resonance imaging (MRI) prior to surgery demonstrated an encapulated solid tumor mass demonstrating fat signal and and increased T2-weighted signal. Postsurgical histological tissue diagnosis was compatible with myolipoma. Recognition of the unusual presentation of this abdominal tumor was essential for accurate surgical planning.