Lipoma is a benign mesenchymal tumour that rarely develops intraorally. Intraoral lipoma usually presents as a slow-growing, painless mass, occasionally interfering with speech and mastication. Here we describe a patient with pedunculated intraoral lipoma causing speech and mastication difficulties. A 48-year-old gentleman presented with a slow-growing, painless intraoral mass causing discomfort while chewing and talking. The mass originated from the buccal mucosa through a thin peduncle. We excised the tumour entirely from its root. Histopathologically it was diagnosed as fibrolipoma. We also conducted a systematic quantitative review of the PubMed database following PRISMA guidelines using specific sets of keywords and defined inclusion and exclusion criteria. Total 44 relevant articles were identified comprising of 175 patients. Their demographic and clinical profiles are described. Most common site of origin is buccal mucosa followed by tongue and lips. The presenting symptoms vary according to the intraoral location of the lesion. Pedunculated origin of intraoral lipoma is an extremely rare presentation. It is difficult to diagnose clinically, but a high degree of clinical suspicion helps in dealing with such cases.