Myelolipomas are benign tumours composed of haematopoietic tissue and mature adipocytes. They occur predominantly in the adrenal glands although rarely extra adrenal sites have been described. Their presentation and location can cause them to be easily confused with a malignant tumour. Here we present a myelolipoma in the paravesical space. To the best of our knowledge this loca­tion has not been reported before. The growing use of imaging will lead to an increase in incidence of these tumours. Understand­ing the natural history and their differentiation from other tumours is therefore important. The purpose of the present report is to raise awareness for this unusual tumour type in this location.