Lingual cyst is a clinical term indicating a cyst occurring within the tongue. Various disease may clinically present as a lingual cyst, such as foregut cyst, dermoid cyst, thyroglossal duct cyst, salivary duct cyst, hemangioma and ranula. In general, lingual cysts are asymptomatic but may cause airway obstruction, feeding or swallowing problems. Most of these lesions can be simply treated by surgical excision with good postoperative healing and low recurrence rate. Apart from that, histopathological diagnosis of the lesion is important because it means the origin of the lesion. Thus it is important to rule out several origins of lingual cyst histopathologically, because it might be related with adjacent anatomical structure or may indicate cysts on other sites. Herein, we reported a case of lingual cyst with columnar epithelium at the ventral tongue of a 46-year old man and reviewed the clinical and histopathological considerations required for further classification in lingual cysts.