The cauda equina is a general term for the peripheral nerves emanating from the sacrococcygeal spinal cord, the 10 pairs of lumboskeletal nerve roots under the cones of the spinal cord, and cauda equina lipoma refers to a lipoma that occurs in the cauda equina. It is usually primarily a benign tumor that requires prompt medical treatment once discovered. Lipoma symptoms in the cauda equina terminal filament, if relatively small, usually no obvious clinical symptoms; if relatively large, may compress the surrounding cauda equina plexus nerves, resulting in symptoms of back and leg pain. Most cauda equina lipomas are benign tumors that do not undergo malignant transformation and are typical of spinal lipomas. Lipoma of the cauda equina may be caused by abnormal granulocytes and degenerative changes, which can cause adipocyte differentiation, leading to the development of lipoma. In severe cases, active medical attention is recommended, with investigations and treatment as prescribed by the doctor.