Supratentorial location of cysts was noted in 75 % cases (n = 24) while 25 % cysts were located infratentorially (n = 8). The mean cyst size was 54 mm in largest dimension (range 10–100 mm; median 50 mm). Hemiparesis was noted in 37 % cases, raised intracranial pressure and seizures in 34 % cases each, while cranial nerve dysfunction was noted in 16 % cases. Seventy five percent cases were surgically managed: excision and marsupialization was done in 53 % cases (n = 17), stereotactic aspiration in 12.5 % cases (n = 4), endoscopic fenestration in 6.25 % cases (n = 2) and cystoperitoneal shunting initially in 1 case (3 % ) and after recurrence of primarily excised cysts in 2 cases. Conservative treatment with regular clinical and imaging control was done in 25 % cases (n = 8). The mean follow-up was 72 months (range: 12–108 months). Good outcome was noted in 72 % cases, 16 % cases remained unchanged while only one case with giant suprasellar cyst worsened. With excision and marsupialization, 65 % of cysts reduced in size (n = 11/17), 17 % cysts resolved completely (n = 3/17). The overall recurrence rate was 29 % . Surgery excision and marsupialization of symptomatic cases provided good results.