Pancreatic cystic neoplasms (PCNs) encompass a wide range of cystic masses found within the pancreas that develop at varying rates in the general population. Some lesions are purely benign, while others carry a higher risk of developing into pancreatic adenocarcinoma or may already have a focus present. It is important to appropriately identify and recognize the type of pancreatic lesion as the management and prognosis for each type of neoplasm vary widely from imaging surveillance to pancreatic resection. Most guidelines for management have been shaped by large multicenter retrospective reviews of patients with pancreatic cystic neoplasms. This chapter will discuss the epidemiology, pathophysiology, imaging, and cytology findings of the most common PCNs as well as their management.