Sublingual epidermoid cysts are rare benign lesions derived from ectodermal tissue, typically located beneath the tongue or the floor of the mouth. While often asymptomatic, these cysts can grow and cause discomfort or complications, making accurate diagnosis and appropriate treatment crucial. We present the case of a 6-year-old Indian girl diagnosed with an implantation keratinized sublingual epidermoid cyst, initially misidentified as a plunging ranula. The cyst caused significant discomfort, prompting further investigation and treatment. A comprehensive review of cases reported in PubMed highlights the characteristics, aetiology, symptoms, diagnostic challenges, complications, treatment options, and prognosis associated with sublingual epidermoid cysts. This review contributes to the understanding of these uncommon lesions, providing insights into their management and the importance of accurate diagnosis.