1. Incidental cystic lesions of the pancreas are being discovered more frequently, occurring in approximately 1% of abdominal imaging studies. 2. Differentiating benign from premalignant or malignant cystic lesions is challenging but important, as it determines appropriate management and surveillance approaches. 3. Current guidelines recommend surgical resection for mucinous pancreatic cystic lesions showing worrisome features such as cyst size over 3 cm, mural nodules, or involvement of the main pancreatic duct, due to their elevated risk of harboring cancer.