The treatment of pituitary cysts is mainly surgical. In the case of a pituitary cyst that is quiescent and has no compressive effect, it can also be observed conservatively for dynamic review. Pituitary cysts, also known as lacunar cysts, are a congenital residue of embryonic development. This congenital cyst is located primarily in the saddle region of the middle cranial fossa. Many patients develop the disease in young adulthood, and the main clinical symptoms include headaches, pituitary dysfunction, and visual dysfunction. The disease cannot be treated with medication or radiation therapy, and the only treatment is surgery. Surgery is preferred to neuroendoscopic transnasal butterfly approach for resection of Lacke’s cyst in the saddle region.