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Thornwaldt cyst (Tc) is a benign mass, usually localized in the median plan of the nasopharynx. It is generate from permanent notochord remainings. The pharyngeal bursa—being an embryological residual—occurs in 3% of healthy adults. Closing of the orifice of a nasopharyngeal bursa results in the occurrence of Tc. When the Tc become infected or inflamed, causing to signs. The general indications for radiologic study in patients are nasopharyngeal symptoms, headache, seizures, and dizziness. Computed tomography is less effective than magnetic resonance imaging in the detection and characterization of Tc. On histopathologic study, the walls of Tc are seen to be infiltrated vaguely by lymphocytes and absent lymph follicles. Asymptomatic patients do not necessitate surgery, whereas symptomatic cysts need surgical treatment by a transnasal or transoral access. Marsupialization is the method of option to avoid recurrence. This review provides fundamental knowledge on Tc from an objective perspective.