The authors describe the case of a 42-year-old-woman with sacral pain for several years. Clinical evaluation, endoanal ultrasound, Computer Tomography and Magnetic Resonance Imaging demonstrated a retro rectal cystic lesion. A Kraske approach was used for excision. Pathology showed a tail gut cyst. A review of the literature is presented. Keywords: tailgut cyst; retrorectal cystic hamartoma; presacral cyst; rec...