Developmental cysts are a subgroup of perirectal cysts seen extremely rarely. They have no symptoms in 50% of cases, and mostly occur among middle-aged women. The ratio of male to female is approximately 1/3. In the differential diagnosis, malignancies and pilonidal cysts are common. Although they usually occur as benign lesions, 30% of cases are reported as malignant in literature. Preoperative diagnosis is quite challenging, but may be essential for appropriate treatment. The main treatment is surgical removal of the entire cyst for the prevention of complications and the potential for malignancy. In addition to the trans-sacral or perineal approach, anterior laparoscopy can be performed as an optional surgical technique.