Cervical spinal synovial and/or ganglion cysts can occur at various periarticular sites and should be considered in the differential diagnosis of intraspinal-extradural or paraspinal masses of the cervical spine. The first report of a ganglion cyst of the cervical anterior longitudinal ligament presenting as a retropharyngeal mass, is presented. The histopathology, etiology, and clinical aspects of synovial and ganglion cysts of the cervical spine are briefly reviewed.