Anechoic cervical lesions are uncommon findings which may entail diagnostic and, therefore, management difficulties. Chronic cervicitis, bulky nabothian cysts, adenomyomas, niches (cesarean scar defects), congenital malformations, and pseudo-neoplastic glandular cervical lesions often raise diagnostic dilemmas; they may also mimic malignant lesions [1–4]. Other anechoic images worth considering are those produced by cystic changes after cervical trauma, lacerations, or extremely rare false passages resulting from cervical dilatation [5]. Methods