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Tumors occurring in the retrorectal space are heterogeneous and uncommon. Multiple embryologie remnants derived froma variety of tissues are found in this space and this explains the heterogeneous pathology of cysts and tumors that arisein retrorectal space. Presacral cysts are rare in adults. Most of the lesions are benign. The cysts may be unilocular ormultilocular. They are often asymptomatic. These tumors pose a diagnostic and therapeutic interest. Presacral epidermoidcystsare classified as a type of developmental cysts.We report the case of a 57-year-old woman who presented with apainless mass posterior of the anus. Imaging studies showed a multilocular cyst (65 × 100 × 60 mm) in the retrorec-tal space. The patient underwent surgery via a posterior approach.Histological study revealed a epidermoid cyst.A reviewof literature of this rare tumor is performed.