Tailgut duplication cyst (retro-rectal cystic hamartoma) is a rare congenital developmental lesion arising from post-natal primitive gut remnants. Tailgut cysts are found more commonly in middle-aged females. It may be asymptomatic or symptomatic in complicated cases. Major differentials include epidermoid cyst, dermoid cyst and anterior meningocele. Unfortunately no radiological sign can specifically diagnose it and surgical resection and histopathology remain the cornerstone for diagnosis. Here we present a case of symptomatic tailgut duplication cyst in an adult male.