Introduction: Bartholin gland cysts are common benign vulvar lesions in women of reproductive age. Large or recurrent cysts can be challenging to treat, particularly when they impact quality of life or body image. This case highlights the surgical management of a giant Bartholin cyst in a postmenopausal woman, with a focus on functional and aesthetic outcomes. Case Presentation: A 47-year-old woman presented with a large right labial mass progressively increasing over several months, associated with discomfort during walking and sitting. Clinical examination revealed a tense, fluctuant cyst arising from the right Bartholin gland. Surgical excision was performed through a concealed mucosal incision on the medial aspect of the labia majora. After removal, excess skin resulting from tissue distension was excised, and a layered closure with absorbable sutures was performed to restore vulvar symmetry. Postoperative recovery was uneventful, with excellent aesthetic and functional results at one month. Discussion: Bartholin cysts exceeding 4–5 cm are rare, particularly in perimenopausal or postmenopausal women. Although marsupialization remains a standard approach, complete excision may be preferred for large or symptomatic cysts. In this case, a targeted aesthetic approach was used by concealing the incision and removing redundant skin to restore anatomical symmetry. The case underlines the importance of individualized surgical planning, particularly in patients concerned about body image and aesthetics. Few reports describe the aesthetic consideration in Bartholin gland surgery, making this case a unique contribution. Conclusion: This case demonstrates that with careful surgical planning, large Bartholin cysts can be effectively treated with attention to both function and vulvar aesthetics. Aesthetic outcomes are increasingly relevant in vulvar surgery and deserve greater attention in the literature.