Cardiac blood cysts are rare with most cases stemming from the pediatric population. The few case reports in adults have not generated clear guidelines regarding management. The finding of a cardiac mass engenders a broad differential including primary cardiac benign tumors, malignant tumors both primary and metastatic, as well as infectious processes in addition to blood cysts. The clinical context, imaging results, and potential for complications must be taken into account when making diagnostic and treatment decisions. We present, to our knowledge, the first case of a giant cardiac blood cyst resected in an adult with a history of tuberculosis.