| Summary: | Odontogenic cysts (OCs) are etiologically diverse conditions with a shared origin in the jaws. Unfortunately, there is a scarcity of published data regarding OC frequency, treatment, and follow-up information in Saudi Arabia, especially from tertiary centers. Objectives: The study aims to assess the relative frequency, clinicopathological features, treatment, and follow-up of OCs in three tertiary medical centers. Methods and Material: OCs were identified from King Abdulaziz Medical City, King Fahad Medical City, and Prince Sultan Military Medical City from January 2010 to December 2021. Results: Three hundred and seventy-two cases of OCs were identified from the archive of three medical centers in Riyadh; one hundred and forty-nine (40%) cases were retrieved from Prince Sultan Military Medical City. The mean age of all OCs was 32 years (range 2–90), with 225 (60.4%) cases occurring in males. There was an almost equal distribution of OCs between the maxilla (47.0%) and the mandible (53.0%). The apical radicular cyst (ARC) accounted for half of the cases, followed by dentigerous cyst (DC) (29.3%) and odontogenic keratocyst (OKC) (14.2%). Enucleation was the most common treatment modality (52.8%), followed by excision (35.0%). Thirteen cases showed recurrence: one ARC, four DCs, and eight OKCs. Conclusion: This is the first large multicenter study of OCs in Riyadh, Saudi Arabia. All three centers showed that ARC was the most common, followed by DC and OKC.
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