Given the increasing use of imaging in the diagnosis process and the technological advances in resolution and quality of the images, many pathologic entities not yet clearly defined, even those asymptomatic, are now incidentally detected. Such is the case with the pancreatic cystic lesions, which could not de diagnosed some 30 years ago because most of them are asymptomatic. The majority of symptomatic cystic lesions that affect the pancreatic parenchyma are due to the presence of non-neoplastic pseudocysts whose management may be just drainage or clinical follow-up, while those asymptomatic cystic lesions are generally neoplastic.