Introduction: Spinal arachnoid cysts (SACs) also called arachnoid diverticula, are uncommon benign lesions that occur in the spinal axis which are indistinct etiology that present with pain or myelopathy. Diagnosis is made incidentally on imaging studies with varying degrees of specificity. In symptomatic cases treatment involves surgical exploration and relief of neural tissue compression.Aim:The aim of this study was to illustrate features of SACs, surgical management, and outcomes.Methods: We are searched medical records for all SACs in adults in the 10-year period ending in December 2018. Radiology and pathology reports were reviewed to exclude spine cystic disorders like syrinx,hydromylia,cystic tumors and recurrent or previously treated patients were excluded. Demographic variables (age, sex) and clinical presentation (symptoms, duration, history of infection or trauma, and examination findings) were extracted. Radiological features were collected and interpreted on imaging studies. Operative findings were reviewed to accurate description ofthe surgical technique. Finally, patient-reported outcomes were analysed at every clinic visit.Results: The authors’ search identified 10 patients with SACs (mean age at presentation 31.5 years). Eight patients were male, representing an almost 4:1(male:female) sex distribution. Symptoms comprised back pain (n = 6, 60%), weakness(n = 6, 60%), gait ataxia (n = 8, 80%), and sphincter dysfunction (n = 3, 30%). The mean duration of symptoms was 8 months. Four patients (40%) exhibited signs of myelopathy. All patients underwent preoperative MRI; SACs were located in the thoracic spine (n = 4,40%), and less commonly in the sacral spine (n = 2, 20%) and cervical/cervico thoracic,thoracolumbar region (n = 1, 10%). Based on imaging findings, the cysts were interpreted as intradural SACs (n = 9, 90%), extradural SACs (n = 1, 10%), or ventral spinal cord herniation (n = 1,10%); All patients underwent surgical treatment consisting of laminoplasty in addition to cyst resection (n = 6, 60%), ligation of the connecting pedicle (n = 1, 10%), or fenestration/marsupialization (n = 3,30%). Postoperatively, patients were followed up for an average of 12.2 months (range 6-18 months). Postoperative MRI showed complete resolution of the SAC in 8 of 10 patients. Patient-reported outcomes showed improvement. One patient suffered a CSF leak with delayed wound infection which treated conservatively and one patient developed recurrent spinal arachnoid cyst underwent redo excision.Conclusions: Spinal arachnoid cysts are rare disease entities,which are idiopathic, incidentally diagnosed and most of them are asymptomatic needs close clinical observational management.In symptomatic patients with imaging findings suggestive of spinal arachnoid cyst with neural compression, surgical exploration and complete resection is the treatment of choice. Treatment is usually well tolerated, carries low risks, and provides the best chances for optimal recovery.