Abstract: The author reported one case of mediastinal angiolipoma of ⁹⁹Tc^m-MIBI SPECT/CT imaging, The characteristics of the disease were introduced according to clinical symptoms, CT, ⁹⁹Tc^m-MIBI SPECT/CT tumor positive imaging and pathological diagnosis, meanwhile, the understanding of mediastinal angiolipoma was deepened by reviewing the literature. The result of imaging findings of ⁹⁹Tc^m-MIBI SPECT/CT showed no significant ingestion. Conclusion suggests that preoperative multiple imaging examinations are helpful to observe the growth pattern and internal components of mediastinal angiolipoma and is helpful for diagnosis and differential diagnosis.