BACKGROUND: Unilateral hypertrophy of the tensor fascia lata muscle is a rare phenomenon with a variety of aetiological causes. It may mimic soft tissue sarcoma, which can lead to misdiagnosis and unnecessary invasive procedures. METHODS: A retrospective review was conducted of all adult patients referred to a statewide sarcoma service lata between January 2010 to June 2023 with confirmed unilateral hypertrophy of the tensor fascia. Their medical records and imaging were reviewed to identify the likely cause. All patients' histories, clinical findings and radiological investigations were reviewed by subspecialised radiologists and orthopaedic surgeons. RESULTS: We identified nine patients with unilateral hypertrophy of the tensor fascia lata muscle. Conservative treatment was recommended to all patients, however one patient who experienced hip pain pursued surgical excision of the tensor fascia lata at another centre, with ongoing pain in the region post-operatively. CONCLUSIONS: With ample awareness of the diagnosis and the imaging findings, this condition can be diagnosed based on history, examination and magnetic resonance imaging. Tissue biopsy and surgical excision are not indicated.