We report a typical case of cystic hygroma presenting in an elderly female patient. A review of the literature on this condition reveals that although rare in adults, it should form part of the differential diagnosis of a cystic swelling in the neck in this group of patients as well as in the more commonly observed juvenile population. The embryology and pathogenesis of lymphangiomata are discussed as well as the recommended management of a cystic hygroma in an older patient.