Splenic epithelial cysts, also known as splenic epidermoid cysts or primary splenic cysts, are unilocular fluid lesions with thin and smooth walls and no enhancement. They represent ~20% of cysts found in the spleen, and are usually an innocuous incidental imaging finding. In practice, both primary and secondary cysts are often described simply as “splenic cyst” for the sake of simplicity, as often the specific etiology is not evident.