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Arachnoid cysts are intra-arachnoid collections of cerebrospinal fluid; congenital in origin, they account for about 1% of all atraumatic intracranial mass lesions. Arachnoid cysts confined to the internal auditory canal are extremely rare. In most patients who has arachnoid cysts in the internal auditory canal, no direct intervention is necessary, but if the neurologic symptoms are progressive, the arachnoid cyst could be drained surgically to relieve the symptoms caused by compression of structures adjacent to the cyst. We present one case of a arachnoid cyst in the left internal auditory canal which was diagnosed by a temporal bone magnetic resonance imaging. Korean J Otorhinolaryngol-Head Neck Surg 2014;57:120-3