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Laparoscopic management of epidermoid cyst in an unusual location. The pararectal space or presacral space is a potential site for various cysts and tumours because it consists of many types of embryonic tissues. Although epidermoid cyst is a well-known entity, encountering a pararectal epidermoid cyst is relatively rare. The incidence of cystic tumours in the pararectal space has been reported to be 1 in 40 000 to 63 000 patients. Most of the tumours are asymptomatic and are incidentally discovered during routine imaging studies. Herein, we report a case of pararectal epidermoid cyst in a 51-year-old woman which was managed laparoscopically in a gastroenterology institute in South India.