Tailgut cysts (TGCs) are rare congenital lesions located in the retrorectal space, often remaining asymptomatic and incidentally discovered. However, when symptomatic, they can cause significant discomfort and may require surgical intervention. We report a case of a 40-year-old female who presented with persistent and severe coccygeal pain that significantly impaired her quality of life. Imaging studies revealed a cystic mass consistent with a TGC. Conservative management, including pain control and physical therapy, was ineffective, leading to the decision to surgical treatment. The patient underwent successful laparoscopic excision of the cyst, resulting in complete resolution of symptoms without postoperative complications or recurrence. This case underscores the importance of considering TGCs in the differential diagnosis of chronic coccygeal pain and demonstrates that laparoscopic surgery is a safe and effective treatment option when conservative approaches fail.