For a large median palatine cyst, 28 years old male was treated by marsupialization technique. The median palatine cyst is defined as a rare fissural nonodontogenic cyst located in the midline of the hard palate, posterior to the incisive canal and palatine papilla. Median palatine cyst is thought to originate from entrapped epithelial remnants during the embryonic phase of fusion of lateral palatal shelves. These epithelial remnants proliferate later in the adult life and form a cyst. The cause of this proliferation is unknown, although sutural movement during mastication or other intraoral bony stresses may play a role in exciting potentially cystic epithelium in fusion areas. A differential diagnosis among the cysts originating from the palate is difficult and many of the cysts are inaccurately diagnosed. Some criteria for establishing a differential diagnosis has been presented. Marsupialization is the preferred treatment for large fissural cysts and enucleation is perferred for small ones.