Objective: Acute hemorrhagic synovial cysts are frequently misdiagnosed because the entity is rare. The purpose of is this article to provide insight on the clinical presentation, diagnosis and surgical treatment of this condition.Summary of background data: Twenty-nine cases reported in the literature were reviewed and presented in this article.Methods: We retrospectively reviewed seven patients with MRI and exam correlated lesions that underwent resection of a synovial cyst. All patients had acute onset of symptoms, defined as less than three months, and all patients had radiographic and histopathologic evidence of hemorrhage into a synovial cyst. Presenting symptoms included paresthesias, motor loss, or pain in the distribution correlating to MRI location of the lesion.Results: All patients showed improvement on physical exam and reduced pain. No patients required further surgical intervention during the follow-up period