RATIONALE: Excision of a benign neck mass is traditionally performed via the transcervical approach. In order to avoid visible scars in the neck, various remote access surgical approaches have been developed. The aim of this report is to present the technique of a transoral endoscopic vestibular approach for treatment of a benign upper neck mass. PATIENT CONCERNS: A 47-year-old female with an anterior upper neck mass and throat discomfort visited our institution. DIAGNOSIS: The computed tomography (CT) scans and ultrasound (US) images demonstrated a benign-appearing mass on the anterior upper neck area. INTERVENTIONS: The benign upper neck mass was successfully removed via the transoral endoscopic vestibular approach, without any complication. OUTCOMES: The final pathologic report indicated that the lesion was an epidermal cyst. The cosmetic result was excellent. LESSONS: From this case study, we can learn to apply a transoral endoscopic vestibular approach for removal of a benign upper neck mass. Based on the outcomes, endoscopic removal of the benign upper neck mass via a transoral vestibular approach can be useful for patients who wish to hide any anterior neck scar.