Background: Abdominal lymphangioma is a rare benign tumor can occur in children but its discovery in adults is very rare. This article was undertaken to study the presentations, diagnostic difficulties and surgical outcome of abdominal cystic lymphangioma in adult patients. Materials and Methods: Clinical and imaging files of thirteen patients with abdominal cystic lymphangioma (ACL) treated in Tanta University hospital during a period of 15 years were reviewed for demographic data, presentations, radiological studies, histopathology and surgical outcome. Results: The study included thirteen patients (8 males and 5 females) between 19 years and 52 years (mean 38.3 years). The main clinical presentation was abdominal mass or enlargement found in 12 patients, Abdominal US and CT highlighted a cystic mass in the mesentery of small bowel, large bowel, greater omentum and retroperitoneum in twelve patients, while the cyst discovered accidentally in one patient during laparoscopic appendectomy. Complete excision of the cyst could be done in eleven patients and incomplete resection in two with the result of recurrence of the cyst in one patient and intestinal obstruction in another patient during the follow up period. Conclusion: Preoperative diagnosis of abdominal lymphangioma is usually difficult due to its variable misleading clinical presentations, rarity of the disease, and its misdiagnosis with other intra-abdominal cysts. Diagnostic imaging studies may help to suspect of the disease, but final diagnosis is confirmed after histopathological examination of excised cyst. The best therapeutic option of ACL is complete surgical excision to avoid the cyst complications and to reduce the risk of its recurrence.