Solitary or true pancreatic cyst is a very rare pathologic condition; only a few cases are reported in literature. We report a case of a 22-year-old woman with a symptomatic true pancreatic cyst located in proximity to the pancreatic head, duodenum, vena cava, biliary tree, and right kidney, which was enucleated through a laparoscopic approach. Laparoscopic ultrasound imaging allowed the surgeon to better identify the morphology of the cyst and its relationship with the adjacent structures. The treatment is briefly reviewed and discussed.