Primary cardiac and pericardiac neoplasm are rare lesions and are less common than the secondary ones. They include both benign and malignant histologic types. Myxoma is the most frequent primary cardiac neoplasm in adult, while rhabdomyoma is the most common neoplasm in children. The pericardial tumors include benign teratom and malignant mesothlioma. However they can be early diagnosed with echocardiography, computed tomography (CT), and magnetic resonance imaging (MRI). Chest X-Ray may reflecting the location of the tumor., while Echocardiography is the preferred initial imaging modality, but CT and MRI add a very specific information in the evaluation of primary cardiac and pericardiac neoplasm as they detect the tumor location, morphologic features and tissue characterization, include the presence of calcification, fat, fibrous tissue, hemorrhage or cyctic changes. This help refine the differential diagnosis.