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Abstract Background Unlike subcutaneous lipomas, thoracic cavity lipomas are extremely rare and can develop to be quite large without causing any symptoms. However, managing massive lipoma that involves both chest cavities is usually challenging, especially when considering the approach for excision. Case We report our experience of surgical management of a case of a 46-year-old male with huge intrathoracic lipoma that extends bilaterally and is known to be the largest of such kind. The tumor was resected successfully using median sternotomy. Histological analysis confirmed features of lipoma. Conclusion To remove a bilateral intrathoracic lipoma, various surgical approaches have been documented. In our experience, a median sternotomy allows better exposure, which aids in complete surgical extirpation resulting in the prevention of recurrence.