The authors report an atypical case of symptomatic entirely suprasellar Rathke's cleft cyst mimicking suprasellar arachnoid cyst. A 55-year-old male was introduced to our hospital complaining of bitemporal hemianopsia. CT and MRI demonstrated a cystic mass located entirely in the suprasellar cistern and to compress the optic nerve and mammillary body. The cystic wall was not enhanced in MRI. CT cisternography showed the suprasellar non-communicating cyst with cistern. The hormonal function was slightly disturbed by the pituitary compression. Under the diagnosis of suprasellar arachnoid cyst, a left front temporal craniotomy was performed to resect the suprasellar mass. The surgical specimen consisted ciliated epithelium and was diagnosed Rathke's cleft cyst. After operation, he recovered completely free.

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