With advances in MR imaging, reports of pineal cyst have become more common. In contrast to pineal neoplasm, a pineal cyst is usually asymptomatic and is detected incidentally. We reviewed six cases of pineal cyst diagnosed between 1991 and 1996. Only one patient presented with syncopal attack due to compression of the midbrain. MRI typically reveals a cystic mass with a mean diameter of 1.66cm and shows faint rim-like contrast enhancement. Since it shows the anatomic relationship of the cyst to the aquedect, sagittal MRI is the most useful diagnost test. In the one symptomatic patient, we performed suboccipital cramiectomy and removed the cyst. It contained clear fluid and was easily removed. Surgery can be considered only when the lesion produces symptoms due to compression of the quadrigeminal plate, aqueduct, or midbrain. The long term behavior of these lesions is, however, unknown, so only with follow-up for long time will appropriate management techniques become apparent.