With the increasingly widespread use of imaging techniques pancreatic cystic lesions (PCLs) are now commonly identified. Their prevalence among the symptom-free population ranges from 2.4% to 13.5%. However, a recent study by our group revealed PCLs in up to 21.5% of patients undergoing endoscopic ultrasound (EUS) for non-pancreas conditions, an incidence that increases with age. Identifying PCLs in an otherwise asymptomatic population has become a significant clinical issue.