It is about a 42 year old male patient diagnosed with a Thoracic Duct Cyst at the left neck who underwent successfully and uncomplicated removal of it. Analyze strategy of treatment, diagnosis, operative technique and literature review. It is extremely rare only a few cases have been reported in bibliography. A neck ultrasound can identify the lesion, also CT scan MRI can improve diagnosis. Pathology report can give finally the diagnosis-Gold standard. Special care should be given to avoid hemorrhage during the operation and complication associated with duct ligation. Radiotherapy and Cyst-venous anastomosis have been reported as alternative treatment. Regular follow up is necessary to diagnose early any kind of complication. Finally operation and further management needs to be done by a experience and well trained team.