Fat storage in a meningioma occurs via two distinct processes: metaplastic change of meningotheliomatous cells into mature adipocytes, or microcystic change and lipidisation of meningioma cells. We report a case of a true metaplastic “lipomatous” meningioma. Differentiation of two distinct types of meningioma lipidisation and their differential diagnosis from other fatcontaining pathologies such as liposarcoma, mucinous cell carcinoma, dermoid and epidermoid tumors are discussed with special reference to the presented case.