The empty sella syndrome (ESS) or otherwise called "arachnoidocele" is a relatively rare syndrome, it occurs more frequently in young women, but hormonal dysfunction seems to occur more in men. There are two types of ESS: the primary and the secondary which is more frequent. ESS can be completely asymptomatic and discovered incidentally on imaging, or in the presence of endocrine, neurological or ophthalmological signs. Central diabetes insipidus (CDI) is a rare manifestation of ESS, it is usually associated with other pituitary disorders and may be due to compression of the pituitary stalk and/or post-pituitary gland. The treatment of ESS is symptomatic and relies on the administration of hormone replacement therapy in the case of hormone deficiency. Surgery is reserved for special situations.