Objectives: We describe a rare case of parapharyngeal space cyst arising from the branchial arches.
Case report: We report the clinical and radiological (CT and MRI) findings. Surgical resection was performed via a transcervical approach.
Conclusion: Branchial cysts arising from the second pouch are the most common benign neck tumors. A parapharyngeal location (type IV in Proctor's classification) is very rare, and only 24 cases have been reported. Based on our observations in this case and a review of the literature, we discuss the differential diagnoses and treatment options.