Intramuscular supraspinatous cysts are rare and usually related to partial supraspinatous tendon tears. Conventional magnetic resonance imaging (MRI) and MRI arthrography are the most commonly used modalities for imaging such rotator cuff pathology. Treatment and follow-up of such cysts is not well documented in the literature. We report the successful conservative management and follow-up of a patient with a supraspinatous cyst. A patient presented with a 2-month history of right shoulder pain following painting and decorating. An MRI scan showed a supraspinatous cyst and thinning of the supraspinatous tendon. The patient was treated conservatively and at 6 months follow-up was found to be asymptomatic. A repeat MRI scan confirmed complete resolution of the supraspinatous cyst.