Thirty-seven-year old woman was admitted to the hospital with the complaint of headache, nausea and vomiting. There were left sided nistagmus and papilledema on neurological examination. A cystic lesion with mural nodule enhancing contrast medium was found on computed tomography (CT). Acute hydrocephalia was characterized by dilatation of the forth, third, and lateral ventricles. The cyst was drained through left sided suboccipital craniectomy and the mural nodule was removed totally. The histopathological examination revealed hemangioblastoma. There was no recurrence on 2-years follow-up CT. We stress on the importance of hemangioblastoma in differential diagnosis of posterior fossa cystic lesions, and discuss the surgical treatment principles of the cystic hemangioblastomas.