Index Super Speciality Hospital, Indore, has once again demonstrated its excellence in advanced medical care by successfully treating an extremely rare and complex case of cystic hygroma. The ENT, Head and Neck Surgery Department performed a highly challenging surgery on a 39-year-old female patient diagnosed with a massive right-sided cystic hygroma. This condition is exceptionally rare, affecting approximately one in 12,000 people, and is most commonly seen in children, with adult cases being among the rarest worldwide. The patient had previously undergone surgery for the same condition in 2019 at a government hospital in Indore, and the disease had reappeared as a recurrence. The three-hour-long surgery was successfully led by Dr. Naveen Agrawal, along with Dr. Chhavi Agrawal, Dr. Anand Sharma, and Dr. Ajinkya Raverkar, reflecting remarkable teamwork and surgical expertise. Pre-operative MRI investigations revealed a huge multiloculated cystic lesion measuring 17 × 8 × 8 centimeters and weighing nearly half a kilogram, located in the right carotid space. The mass was displacing the right carotid artery and internal jugular vein in opposite directions, making the procedure extremely high-risk. Due to the previous surgery, dense fibrosis bands were present, further increasing the complexity of the operation. Despite these challenges, the surgical team performed meticulous and delicate dissection, carefully preserving all vital blood vessels and surrounding structures. Using advanced microsurgical techniques, the fibrosis bands were safely released, and the entire cyst was successfully removed in one piece (in toto). The removal of such a large mass from a sensitive neck region highlights the hospital’s advanced infrastructure and the surgeons’ exceptional precision. Cystic hygroma is a rare congenital disorder caused by abnormal development of the lymphatic system. It most commonly affects the head and neck region, accounting for nearly 60–70% of cases, while the remaining cases may involve the chest, abdomen, limbs, or axilla. If left untreated, the swelling gradually increases in size, potentially leading to loss of function of the affected area, discoloration, pain, and recurrent infections. Adult cases are particularly rare and often pose significant diagnostic and surgical challenges. The successful management of this complex case at Index Super Speciality Hospital stands as a testament to its commitment to delivering world-class, patient-centric healthcare through expertise, technology, and compassion..