The intraneural ganglion cyst is a rare clinical entity. It is a non-neoplastic mucinous cyst that occurs in the epineurium of a peripheral nerve. It is most commonly described in the lower extremity at the head of the fibula involving the peroneal nerve, although the tibial and sciatic nerves also have been involved to a lesser degree. At the upper extremity, the suprascapular, radial, posterior interosseous, median, and ulnar nerves can be affected. More than 300 cases of peroneal ganglion cysts have been reported since 1810, but only 14 cases in the pediatric population (patients <16 years of age). The clinical presentation may vary, but includes pain, motor and or sensory dysfunction of the affected nerve. It also may present as a palpable mass. The differential diagnosis should include extraneural ganglion and cystic nerve sheath tumors benign or malignant. Several theories regarding the mechanism of formation have been described, including the extra-articular embryonic remnants, epi or perineurial mucosa degeneration, cystic degeneration, and lastly the origin is in the synovial joint allowing the synovial fluid to travel within the epineurium of the articular branch supplying the joint. The latter is referred as the unifying theory. The preoperative evaluation must include taking the patient’s history and a thorough physical examination. Electrophysiologic studies are helpful. Ultrasonography can be used to document the size of the intraneural cyst, and magnetic resonance imaging can better document the solid components and enhancement features that can be useful to the surgeon. Intraoperatively, the cyst can be 2e10 cm distal to the common peroneal nerve. The articular branch connects the cyst to the superior tibiofibular articulation. The cyst content is aspirated and external and or internal neurolysis of the nerve performed. Postoperatively, the patient’s motor function might improve or remain the same, but his or her pain usually will improve. The recognition and the ligation of the articular branch are important to treat this