We describe a case of sacral perineural cyst presenting with complaints of low 
back pain with neurological claudication. The patient was treated by laminectomy 
and excision of the cyst. Tarlov cysts (sacral perineural cysts) are nerve root 
cysts found most commonly in the sacral roots, arising between the covering 
layer of the perineurium and the endoneurium near the dorsal root ganglion. The 
incidence of Tarlov cysts is 5% and most of them are asymptomatic, usually 
detected as incidental findings on MRI. Symptomatic Tarlov cysts are extremely 
rare, commonly presenting as sacral or lumbar pain syndromes, sciatica or rarely 
as cauda equina syndrome. Tarlov cysts should be considered in the differential 
diagnosis of patients presenting with these complaints.