Rupture of intracranial dermoid cysts (RICDC) is a rare phenomenon. The mechanism of rupture, pathophysiology of fat in the ventricles and subarachnoid spaces, possible complications, and proper management of such conditions are proposed on the basis of a review of the literature and experience with two cases of ruptured intracranial dermoid cysts (One was in the pineal region, while another was in the fourth ventricle).