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). It is concluded that rupture of intracranial dermoid cysts is usually spontaneous and non-fatal. Persistence of fat in the subarachnoid spaces postoperatively may last asymptomatically for years. Surgery is the only way to deal with these benign lesions. If the capsule is adherent to vital areas, incomplete removal is advised as recurrence and malignant transformation are unlikely to occur.