Cervical teratomas are very rare tumors. Actually, most of the times they appear as a cervical extension of a mediastinal teratoma due or to intracystic haemorrhage and/or a higher content of pancreatic tissue. Progressive growth and compression on adjacent organs, as the tracheo-bronchial tract in our case, can be the arising symptoms that determine hospital admission of the patient. Histologically, they are classified as mature, benign in 95% of cases, immature and malignant tranformation. Complete surgical removal is the elective treatment. We report a rare case with significant respiratory symptoms due to extrinsic compression and a review of the literature.