Lipomeningocele is a form of spina bifida occulta. Spina bifida occulta differs from the more common forms of spina bifida in that the defects of the spinal cord and/or spinal column are covered by skin. In lipomeningocele, there is a fatty mass extending into the spinal cord and attached to a tethered spinal cord, with no outer exposed neural tissue. The prevalence of lipomeningocele is 0.3 to 0.6 per 10,000 live births. It most commonly presents at birth as a fatty mass in the lower back, although some infants may appear normal. Patients may begin experiencing neurological deficits in early childhood, including weakness, numbness and back pain. Surgery can in most cases untether the spinal cord and reduce the fatty mass to improve outcomes.