Intraosseous lipomas have been reported as rare tumors in the lower extremity. They have been identified in the tibia, fibula, metatarsals, and calcaneus. They are frequently misdiagnosed as other tumors, especially unicameral bone cysts or aneutysmal bone cysts when found within the calcaneus. A detailed description of intraosseous calcaneal lipomas and their treatment is given. Surgical technique and four case reports are presented. One of the cases involved a pathologic calcaneal fracture, a finding to the authors' knowledge that has not been previously reported.