The Wheat Dreamz is a pillow filled with Organic Buckwheat Hulls. They actually conform to your head while giving you the best cervical support ever and it is also Chiropractor recommended. The basic pillow is 17"x 21" and comes with a custom sized pillow case. The large pillow is 20"x 25", the size of a standard pillow, therefore it does not come with the pillow case. Both sizes are available with an organic cotton zippered cover. Whether you're a side or back sleeper, you can shape it to fit you. If your ear needs to breathe, you can make a little cup for it in the pillow and it will stay there. I know, I have one and my ear needs to breathe! The Wheat Dreamz buckwheat is grown without pesticides or herbicides. 4 lbs. of organically grown buckwheat hulls are used to fill a soft ,durable, organic cotton or unbleached cotton shell that has a zipper. This way, you can add or remove hulls until the pillow "Fits" just right. A free natural cotton 200 count pillowcase is included with the basic size Wheat Dreamz pillow. This terrific organic buckwheat hull pillow: Conforms to your head and neck contours. Is thermodynamic so it doesn't conduct heat. Has a soft cotton shell made with a hidden zipper. The basic 17"x 21" is perfect to sleep on and for travel. 20"x 25" is a standard pillow size. That is huge in terms of a buckwheat pillow. * Note: The 20"x 25" size uses a standard pillowcase so a "custom" free one is not included.