A case of 58-year-old man with rimmed vacoule myopathy was reported, who had limb-girdle distribution of muscle weakness and atrophy, and had a boule musculaire in the left quadriceps muscle. Muscle biopsy was done in the quadriceps muscle neighbouring boule musculaire, and the specimen showed rimmed vacuoles in 7.6% of the muscle fibers, which appeared mainly in the border between muscle fibers and degenerative fat. Almost all of the rimmed vacuoles were observed in type 1 fibers, and occupied with many membranous whorls and myelin debris.