Cerebral cysts can occur in the context of brain tumors such as glioblastoma, craniopharygioma, and brain metastasis. They can cause significant neurological decline which can result in death. Intracavitary reservoir systems, such as Ommaya reservoirs, have been used for the administration of chemotherapy to treat CSF dissemination of cancer cells. However, Ommaya reservoirs can also be used to facilitate cyst aspirations for patients whose tumor has a cystic component. Previous reports suggest that aspirations via Ommaya reservoirs can provide clinical improvement in patients with cerebral cysts resulting from craniopharyngiomas, gliomas, and cystic metastases. Furthermore, Ommaya reservoirs may be a safe, convenient method for cyst aspiration in patients with delayed cyst formation from gamma knife radiosurgery. However, there are few studies describing the effects of long-term treatment with aspirations. We report on the long-term outcomes of four patients with cerebral cysts treated with Ommaya reservoir aspiration.