Objective: In this study we aimed to review the surgical outcomes of primary mediastinal cysts and to determine the differences among various histopathological types. Methods: We retrospectively analyzed the medical records of 41 patients (19 men, 22 women; mean age 46.5±13.7 years, range 19-78 years) with primary mediastinal cysts who underwent surgical excision betweeen January 2007 and January 2016. Age, sex, indication for surgical intervention, surgical technique, histopathological diagnosis, postoperative complications, and duration of hospital stay were recorded for all patients. The differences among the various histological types of primary mediastinal cysts were determined using analysis of variance (ANOVA) for continuous variables and Chi-square test for categoric variables. A p value of less than 0.05 was considered statistically significant. Results: A total of 41 patients with primary mediastinal cysts were managed surgically at our clinic over a period of 9 years. A total of 19 men (46.3%) and 22 women (53.7%) were included in the study. The patients had a mean age of 46.5±13.7 years, a mean duration of hospital stay of 4.0±1.0 days, and a mean postoperative follw-up duration of 11.2±3.7 months. According to the histopathological analysis, 21 (51.2%) patients were diagnosed as having a pericardial cyst; 16 (39%) had a bronchogenic cyst; 3 (7.3%) had a cystic hygroma; and 1 (2.4%) had a thymic cyst. No postoperative mortality or recurrence was observed over a period of 11.2±3.7 months. No statistically significant difference was found among the variables, either. Conclusion: Despite advanced non-invasive diagnostic techniques, the definitive diagnosis of primary mediastinal cysts can only be made by interventional techniques. Surgery often provides curative therapy with low morbidity and mortality.