Pancreatic intraductal mucinous neoplasms are cystic lesions of the pancreas that have a potential to progress to pancreatic carcinoma, hence prompt and early recognition with surgical resection of high-risk lesions is of paramount importance. The differential diagnosis on imaging and histology includes pancreatic pseudocysts, mucinous cystadenomas of pancreas, pancreatic intraepithelial neoplasia, intraductal oncocytic pancreatic neoplasm (IOPN), intraductal tubulopapillary neoplasm (ITPN) and retention cysts. Diagnosis is mainly by clinical and radiological features. Cytology may be helpful if adequate sample is obtained. The clinical management of these tumours is a constantly evolving with current approach being surgical resection of tumours over 10mm and close radiological and tumour marker follow up for smaller lesions. Prognosis is highly dependent on main duct versus branch duct involvement, presence of high-grade lesions and associated invasive carcinoma component.