Fat tissue is essential not only for energy storage and thermoregulation but also plays critical roles in hormone regulation and immune defense. Disorders related to fat distribution, such as lipomatosis and lipodystrophies, are less understood compared to conditions like obesity and anorexia, which have received considerable attention due to their associated health complications, including diabetes and hypertension. Lipomatosis is characterized by excessive growth of adipose tissue, with variations including isolated subcutaneous lipomatosis and syndromic forms linked to genetic pathways. Depending on the condition, either subcutaneous or visceral fat may be affected, leading to a spectrum of clinical manifestations. Current knowledge surrounding the pathophysiology of these disorders remains limited, with inflammation and impaired lymphatic drainage being implicated in disease progression. Diagnosis relies heavily on clinical assessment, as there are no standardized criteria to differentiate among lipomatoses or from obesity. Imaging techniques and biochemical markers may aid in diagnosis but remain under investigation. Treatment strategies typically aim to alleviate symptoms and prevent complications, with liposuction and lipectomy being common interventions. Additionally, comprehensive management approaches may include lifestyle modifications and physical therapy to address associated lymphedema. Continued research into the etiology and effective management of lipomatosis is essential for improving patient outcomes and expanding our understanding of these complex disorders.