Lim VM, et al. - Patients specifically diagnosed with pudendal neuralgia were examined for the prevalence of S2–S4 Tarlov cysts at the pudendal nerve origin (S2–S4 sacral nerve roots), and further, an association of patient symptoms with the location of Tarlov cyst was determined. In this retrospective study of 242 patients with pudendal neuralgia who were referred for pelvic MRI from January 2010 to November 2012, 39 (16.1%) patients exhibited at least 1 sacral Tarlov cyst and a total of 50 Tarlov cysts were identified. The analysis revealed no significant correlation between cyst size and pain laterality, cyst volume and pain location, or cyst size and unilateral vs bilateral pain. Observation revealed no likely causative role of the increased prevalence of Tarlov cysts in pudendal neuralgia, yet both could be due to similar pathogenesis from part of a focal or generalized condition.