A pericardial cyst is a rare finding and is frequently congenital in etiology. Pericardial cysts are most commonly incidental findings and have no clinical significance. Cardiac tamponade has been reported, although is exceedingly rare from this condition. Diagnosis is made on echocardiography or by computed tomography (CT). Pericardial cysts are surgically resected if symptoms are present, if they are very large in size, and if the etiology is unclear since on rare occasion metastatic disease to the pericardium can look cystic.