A new study published in World Neurosurgery found that despite longer preoperative duration than the pediatric population, adult patients with lumbosacral lipomas can benefit from total/near-total resection especially regarding pain and foot ulcers, with a low surgical-related morbidity rate. This study reviewed the treatment of patients with congenital intraspinal lipomas with total/near-total resection and discussed their preoperative characteristics, prognostic factors and surgical outcomes. Here, medical records of 122 patients with congenital lumbosacral lipomas, undergoing total/near-total resection, were systematically analyzed. These patients were subdivided into three groups depending on symptom onset age: Group-1 consisted of 40 patients with ≤5 years of onset; Group-2 comprised 33 patients between 5-18 years of onset; while Group-3 had 49 patients with >18 years of onset. The findings revealed that the most common symptom was bladder dysfunction in 82% of the patients, followed by constipation in 76.2%. At the 3-month follow-up. Improvement was noted in most patients presenting with pain and neuropathic ulcers. Additionally, the overall neurological status improved in 73% of the patients and stabilized in 19.7%. Furthermore, shorter preoperative duration and preoperative pain were found to be independent predictors of postoperative improvement. However, neurosurgical complications developed in 16 patients, and wound complications occurred in 2 patients. Two out of three patients who had recurrent symptoms underwent repeated detethering surgery during long-term follow-up.