In 1985 to 2000, the Academician N. N. Burdenko Research Institute of Neurosurgery, Russian Academy of Medical Sciences, examined and operated on 78 patients with epidermoidal cysts of the posterior cranial fossa. A complex of clinical symptoms of epidermoidal cysts of the posterior cranial fossa and their computed tomographic (CT) and magnetic resonance imaging (MRI) scans were studied. Based on clinical and X-ray evidence, their diagnosis was correctly made in 87.2% of cases. A procedure was developed for radical removal of epidermoidal cysts of the posterior cranial fossa. The stages and surgical treatment policy were elaborated. Total tumor removal was made in 81.25% of the patients. In other cases, a part of a capsule was left due to its close relationship to the adjacent neurovascular structures. Two patients with epidermoidal cysts of the cerebellopontile angle who had undergone radical tumor removal died in the immediate postoperative period. The cause of the two patients were ischemic attack in the brain stem. The quality of surgical treatment was assessed by examining changes in the patients' neurological status, CT and MRI evidence prior to surgery and in different periods after it. Recent radiological studies and microsurgical techniques completely ensure radical removal of epidermoidal cysts of by yielding a good postoperative outcome.