Mediastinal teratomas, originating from pluripotent embryonic cells, are uncommon germ cell tumors that contain tissues from all three germ layers. Despite being the most frequent germ cell tumors in the mediastinum, they remain rare overall. This case describes a 19-year-old male who presented with chest pain, shortness of breath, and difficulty in swallowing and was ultimately diagnosed with a mature cystic teratoma in the anterior mediastinum. Imaging and histopathological analysis confirmed a large cystic teratoma, which was successfully removed via median sternotomy. Although the postoperative period was complicated by air leaks, infections, and an extended hospital stay, the patient fully recovered and was symptom-free at the one-month follow-up. This case underscores the value of comprehensive diagnostic assessment and demonstrates the favorable prognosis associated with complete surgical removal of thymic teratomas.