Objective. The imaging characteristics of lipoma arborescens using plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) are described. Design and patients. Five patients with a diagnosis of lipoma arborescens are presented. Three had monoarticular involvement of the knee joint. In the remaining two patients both knees and both hips, respectively, were affected. All patients were examined using plain radiographs and MRI. CT was employed in two cases. Results and conclusions. A conclusive diagnosis with exclusion of other synovial pathologies having similar clinical and radiological behaviour can be achieved on the basis of the MRI characteristics of lipoma arborescens. The aetiology of lipoma arborescens remains unknown, but its association with previous pathology of the affected joints in all our patients supports the theory of a non-neoplastic reactive process involving the synovial membrane.