摘要Pancreatic cystic neoplasms present a complex diagnostic scenario encompassing low-and high-grade malignancies. Their prevalence varies widely, notably increasing with age, reaching 75％in individuals older than 80 years. Accurate diagnosis is crucial, as errors occur in approximately one-third of resected cysts discovered incidentally. Various imaging modalities such as computed tomography, magnetic resonance imaging, and endoscopic techniques are available to address this challenge. However, risk stratification remains problematic, with guideline inconsistencies and diagnostic accuracy varying according to cyst type. This review proposed a stepwise management approach, considering patient factors, imaging results, and specific features. This patient-centered model offers a structured framework for optimizing the care of individuals with pancreatic cystic neoplasms.