Background: Scalp dermoid cysts are subcutaneous sacs lined with a stratified squamous epithelium containing developmentally mature ectodermal tissues, including skin, hair follicles, sweat glands, and sebaceous glands. Methods: Because they consist of developmentally mature tissues, scalp dermoid cysts are generally benign. Typically, cysts are limited to an extracranial location, and management generally involves simple surgical resection. Discussion: Because of the potential for intracranial and/or intradural extension associated with some scalp dermoids, however, a comprehensive clinical evaluation incorporating MRI and CT imaging is included in the diagnostic process. © 2012 Springer-Verlag Berlin Heidelberg.