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Benign teratomas of the mediastinum are rare tumors that represent 5 to 10% of mediastinal tumors. They remain asymptomatic for a long time and their discovery often reveals their bulky size. They occur most often in young subjects. We report the observation of a 6-year-old patient with a large mediastinal teratoma revealed by rest dyspnea and chest pain in a context of asthenia who was referred to our pediatric imaging department for a thoracic CT scan. Although benign mediastinal teratomas are slow growing, they can rarely become complicated and cause symptoms. Imaging is essential to make the diagnosis and to look for possible complications. The gold standard treatment is complete surgical resection.