Retrorectal cystic hamartomas (“Tailgut cysts”) are rare developmental cysts that appear in the retrorectal space, arising from aberrant remnants of the post-anal primitive gut in case of an incomplete embryogenetic involution. We present the case of a 30-year-old woman with a history of chronic lower abdominal pain. Other digestive symptoms, like rectal fullness, constipation, pain on defecation, rectal bleeding or genitourinary obstruction symptoms were not associated. During a period of 3 years she had undergone several surgical procedures for ovarian cysts, without relieving the symptomatology. CT scan showed a presacral tumor with a right pararectal development. A surgical resection of the lesion using an anterior approach was performed, with the final pathological diagnosis of a retrorectal cystic hamartoma (“tailgut cyst”). This case underlines the fact that retrorectal masses can be challenging to diagnose and tailgut cysts must be taken into consideration in cases of perirectal tumors at patients with a history of multiple failed procedures and surgeries.