Myelolipomas are rare, nonfunctioning, benign lesions composed of varying proportions of fat and bone marrow elements. The clinical and pathologic features are described with a brief discussion of the possible etiology and pathogenesis. Forty-seven cases in the world literature are reviewed including two of our patients. Twenty-four patients were seen initially with pain, 19 had hypertension, 15 were obese, and seven had hematuria. These tumors can be diagnosed by their characteristic appearance on ultrasonography, computerized tomography, and angiography and by their lack of hormonal alterations.