The spindle cell variant is a histologic subtype of lipoma that is rarely found in the oral cavity. Forty cases of oral spindle cell lipoma have been reported in the literature. A new case of a 71-year-old man with an asymptomatic buccal mucosal lesion is presented here. The lesion was removed locally and was sent for histopathologic diagnosis, and a final diagnosis of spindle cell lipoma was made. A literature review identified that the most common intraoral location of spindle cell lipoma is the tongue, with a male predilection for this specific lesion.