Purpose. The Sylvian (or lateral) fissure is an important structure that has both pathophysiological and microneurosurgical significance. The aims of this review were to revisit the anatomy of the Sylvian fissure and cistern and its overlying arachnoid membrane, and to review its role in the treatment of various surgical pathological lesions. Methods. For the most part, a PubMed search was used in obtaining English abstracts and full-text references for this article. The criterion for inclusion of an article in the references for this review was that it included materials about the anatomical or the clinical properties of the Sylvian fissure, cistern and arachnoid membrane. The relevant books were also used in obtaining supplementary citations. Results. The review presented the anatomy and disease states associated with the Sylvian fissure. Conclusions. A good knowledge of the anatomy of the Sylvian fissure, cistern and its associated arachnoid mater is crucial in the proper diagnosis and neurosurgical management of various pathological conditions.