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Objective: Mistake in diagnosis Background: Lipomas, the most common soft tissue tumors, represent almost half of all benign mesenchymal neoplasms and are characterized by the absence of symptoms. However, if they grow in a laryngeal site, they can cause dyspnea and dysphonia which represents one of the major symptoms of benign laryngeal diseases (such as polyps or nodules); these symptoms are often the first symptom of neoplastic diseases. Case report: We present a case of a 28-year-old female patient with a rounded pseudocyst neoformation located in the left aryepiglottic fold that partially hid the homolateral vocal cord and limited its mobility. Due to the site of the lesion and MRI images showing a well-capsulated neoformation without contrast enhancement, we decided to surgically remove it with a micro-laryngoscopic approach after an evaluation of the patient's upper airway by an anesthetist. This case demonstrates that a micro-endoscopic approach using transoral laser microsurgery for surgical excision was useful for removing the entire mass and avoiding relapses. Conclusions: Laryngeal lipomas are benign and rare lesions, in particular intrinsic lipomas are uncommon, but, if they grow, they can cause life-threatening symptoms. In our case, a lipoma reached a size of around 2 centimeters and was not pedunculated, only a histopathological examination of the surgical specimens could provide a differential diagnosis against a lipoma-like liposarcoma. The use of Transoral Laser CO2 Micro-laryngoscopy (TLM) provided good management of a small intrinsic lipomas of the larynx, minimizing the potential for relapses. [ABSTRACT FROM AUTHOR]