The European Study Group on Cystic Tumours of the Pancreas has developed evidence-based guidelines for the management of pancreatic cystic neoplasms (PCN). These guidelines, which replace the 2013 European consensus statement, are a joint initiative of several European medical societies and involve both European and non-European experts. The guidelines cover nine topics: biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm (SCN), rare cysts, (neo)adjuvant treatment, and pathology. Recommendations include conservative management for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule, and relative and absolute indications for surgery in IPMN based on various clinical factors. The guidelines aim to improve the diagnosis and management of PCN and identify areas requiring further research.The European Study Group on Cystic Tumours of the Pancreas has developed evidence-based guidelines for the management of pancreatic cystic neoplasms (PCN). These guidelines, which replace the 2013 European consensus statement, are a joint initiative of several European medical societies and involve both European and non-European experts. The guidelines cover nine topics: biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm (SCN), rare cysts, (neo)adjuvant treatment, and pathology. Recommendations include conservative management for asymptomatic MCN and IPMN measuring <40 mm without an enhancing nodule, and relative and absolute indications for surgery in IPMN based on various clinical factors. The guidelines aim to improve the diagnosis and management of PCN and identify areas requiring further research.