Nasopharynx (NP) is anatomically difficult to explore adequately. The pharyngeal bursa (PB) is a recess lined with respiratory epitheliumalong the posterior wall of the nasopharynx between the longus capitis muscles. If the opening through which the bursa drains into the nasopharynx becomes obstructed, a Thornwaldt's cyst (TC) might develop. Small-sized cysts are mostly asymptomatic, whereas large-sized cysts may lead to various nasal and otologic symptoms depending on their localization. In this report, we present a 71-year-old case with a huge TC who presented to our clinic with the complaints of snoring, nasal obstruction, periodic halitosis, postnasal drip, headache, and hearing loss in the left ear and underwent total excision of the cyst through transnasal endoscopy. The diagnosis and treatment characteristics of the case are presented with the review of the literature.