The parents are worried about their child, who has become alive again for a while, and they can’t afford to send him to the hospital for an operation. Why does the child usually look normal? Do we have to operate? Is it possible without surgery? Most pediatric intracranial cysts are arachnoid cysts (ICAC), which are benign occupying lesions located within the arachnoid membrane and containing cerebrospinal fluid, accounting for 1% of intracranial occupying lesions, most of which are congenital and 75% are found in childhood. Acquired factors such as subarachnoid adhesions after trauma, inflammation or hemorrhage can also be produced. The clinical detection rate has increased significantly and accounts for 13% of intracranial occupying lesions. The middle cranial fossa is the most common site of ICAC, accounting for 50%-60%, while other sites such as occipital pool, tetrahymenal pool, pars falciformis, intra-lateral ventricle, and triple ventricle can also occur. The symptoms and signs are related to the size of the cyst and the adjacent neurological structures under pressure, because the cyst increases slowly, the clinical symptoms become relatively insidious, but the occupying effect of the cyst causes the child to gradually develop symptoms such as headache, enlarged head circumference and limited temporal bulge. Some patients have abnormal behavior, inattention or learning difficulties. In children, in order to ensure normal brain development and sound brain function, active treatment is recommended once the cyst is detected, unless the lesion is small and the surrounding tissue deformation is minimal, which can be followed up and observed, and once the cyst increases in size over time, surgical treatment is performed. For surgery, the methods used in the past were cyst-abdominal shunt or craniotomy, which had some therapeutic effect, but the shunts left in the body or the trauma of craniotomy caused some psychological burden and fear to the children and parents. In the past 4 years, the pediatric neurosurgery department of the hospital has adopted the most advanced neuroendoscopic minimally invasive locking hole treatment for intracranial cysts, which has relieved the parents of the children’s worries.