We report two rare cases of median nerve fibrolipomatous hamartoma ( FLH ) . The first case involved a 31-year-old male who presented with numbness of the right fingers, palm swelling, and impaired thumb opposition. Carpal tunnel release and biopsy were performed because schwannoma was suspected based on the patient's magnetic resonance imaging ( MRI ) findings. However, the pathological diagnosis was FLH. Since intense numbness persisted for one month after the procedure, we resected an 18-cm section of the median nerve including the tumor and carried out nerve reconstruction with a bilateral sural nerve graft. In addition, we transferred the flexor digitorum superficialis of the ring finger to enable thumb opposition. In the thirteen years since the surgery, the patient has almost completely regained the sensation in the median nerve area and is able to perform thumb opposition. The second case involved a 20-year-old male, who presented with numbness of the right palm. FLH was diagnosed based on the patient's MRI findings, and carpal tunnel release was performed. Although the tumor has not grown since, the numbness of the palm persists.