Rathke cleft cysts are benign lesions of the sellar and suprasellar region. Extrasellar intrasphenoidal Rathke cleft cysts are rare with only one case reported in pediatric age group. The presenting complaints described include headache and diplopia. We report a case of intrasphenoidal Rathke cleft cyst in a 15-year-old girl who presented with headache and visual disturbances. Neuroimaging showed an expansile cystic lesion involving the sphenoid sinus with mass effect over the pituitary and optic chiasma. Endoscopic decompression of the cystic lesion was done and histopathology of the cyst wall revealed it to be Rathke cleft cyst. Follow-up MRI showed total resection of the cystic lesion with residual partial left optic nerve atrophy.