Background <p>To report a rare case of cervical Tarlov cyst successfully treated using a percutaneous uniaxial endoscopic fenestration.</p> Methods <p>This was a single case report describing the surgical technique, clinical assessment, radiological verification, and long-term follow-up outcomes of percutaneous uniaxial endoscopic surgery for symptomatic cervical Tarlov cyst.</p> Clinical presentation <p>A 43-year-old male patient presented with intermittent pain and numbness in his right forearm for 2 years, with exacerbation over the past month. The symptoms were aggravated by fatigue and upon waking in the morning, and conservative treatment yielded no effect. MRI revealed a C8 Tarlov cyst. The patient underwent cervical percutaneous endoscopic laminar decompression and Tarlov cyst resection. Cervical MRI performed on the 2nd postoperative day confirmed complete cyst resection. Postoperatively, the patient’s radicular pain almost completely resolved without symptoms of cerebrospinal fluid leakage, and no recurrence of pain was reported during a 2-year follow-up.</p> Conclusion <p>This case report describes the safe and successful application of percutaneous uniaxial endoscopic fenestration combined with cervical Tarlov cyst resection.</p>