This chapter presents five cases of pancreatic solid pseudopapillary neoplasm (SPN), a rare low-grade malignant tumor, illustrating its diverse clinical and imaging manifestations. The cases include a male patient (atypical demographic), a tumor without significant hemorrhage, a rare instance of multiple synchronous SPNs, a locally aggressive case with splenic invasion, and an advanced case presenting with multiple liver metastases. Each case provides detailed imaging (CT and MRI) descriptions, pathological findings, and differential diagnoses. The chapter highlights key diagnostic features such as the characteristic pseudopapillary architecture, nuclear β-catenin positivity on immunohistochemistry, and the typical progressive enhancement pattern on imaging. It emphasizes the importance of distinguishing SPN from more common pancreatic neoplasms (e.g., neuroendocrine tumors, adenocarcinoma) and discusses its generally favorable prognosis despite rare aggressive or metastatic behavior. Surgical resection remains the cornerstone of treatment.