The spectrum of pancreatic lesions is wide ranging from benign cystic lesions to aggressive invasive cancers. The early manifestations of the pancreatic lesions are nonspecific and quite often discovered incidentally on routine imaging for unrelated medical problems. The assessment of the pancreatic lesions requires linking patient symptoms, physical exam, interpretation of the laboratory and imaging findings to establish a diagnosis, which can be very challenging in the emergency department or primary care settings. The management of pancreatic lesions requires a multidisciplinary approach to provide high-quality care to the patients. In light of the complexity of diagnosing and managing pancreatic lesions in primary care and ED settings, a guidance on pancreatic lesions is necessary. In this chapter, we provide guidelines for the evaluation and management of pancreatic lesions and referral for surgical assessment.