Sacrococcygeal tumors are present most frequently in infancy and childhood. Incidence in the newborn is 1 in 40000 with a female to male ratio of 10:1. It is rare in adults. Less than a hundred cases of teratoma in adults have been documented in literature. Constipation is a common complain; that is refractory to treatment or results in complications such as fecal impaction warrants consideration of occult causes. In most cases, it is diagnosed in childhood, with most descriptions being found in the pediatric literature. It is extremely uncommon for the syndrome to present in adulthood. We report a case of sacrococcygeal teratoma in adult, which has treated in our hospital. The presented case has shown a large thin walled cystic pre-sacral, retro-rectal cystic mass along the intra-luminal recto-sigmoid rounded ball of fecolith. Here, we highlighted the association of sacrococcygeal cystic teratoma in adult male with fecolith, which is rarely documented. So, we should also search the cause of constipation in adulthood, not only in paediatric age-group; that is refractory to treatment or results in complications such as fecal impaction.