Purpose of the Review <p>This article aims to summarize contemporary understanding and management strategies of lipedema. It will elucidate recent advancements in diagnostic methodologies, the role of imaging technologies, and evolving therapeutic interventions. The article will further delineate critical areas that warrant further investigation.</p> Recent Findings <p>Lipedema, often termed a loose connective tissue disorder, is characterized by a disproportionate accumulation of adipose tissue in the lower body. The pathophysiology may include abnormalities in the interstitial fluid and extracellular matrix, along with fibrosis, inflammation, and endothelial dysfunction. Diagnostic imaging may be useful in differentiating from phenotypically similar conditions. In the absence of coexisting lymphatic dysfunction, the role of compression and manual lymphatic drainage is unclear. The optimization of nutrition and the incorporation of an exercise regimen are crucial to managing patient symptoms. Evidence-based weight loss strategies, including medical therapy, should be considered in individuals with concomitant obesity. Bariatric surgery and liposuction may be considered in select patients who have ongoing symptoms despite the optimization of conservative measures.</p> Summary <p>Since it was first described, lipedema management strategies have largely mirrored lymphedema management. However, robust clinical evidence regarding efficacy is lacking. Rigorous clinical trials of lipedema therapies are essential to further our understanding of this disease and ultimately improve the lives of patients.</p>