Pancreatic cystic neoplasms are more increasingly recognized due to the rapid development and widespread use of imaging modalities. It is reported that up to 20% of abdominal cross-sectional images identify incidental asymptomatic pancreatic cysts. Although their accurate differentiation remain difficult because of their overlapping morphologies, proper characterization of pancreatic cystic neoplasm considering imaging finding is important not only to recognize premalignant lesions that will require surgical intervention, but also to allow noninvasive treatment of many cystic neoplasm of the pancreas. Though reliable biomarkers are lacking, imaging plays an important role in directing clinical management and decision making in cases of pancreatic cystic neoplasm. In this topic, a multimodality imaging approach including other cross-sectional imaging studies will be addressed with systemic recognition for morphological subcategory based on imaging morphology of pancreatic cystic neoplasms to avoid unnecessary exposure to invasive treatment.