Abstract: With the development of modern imaging technology and improvement of physical examination consciousness of people, the incidence of pancreatic cystic neoplasm (PCN) has increased significantly. The overall prognosis of PCN is good, and great progress in surgical techniques and multidisciplinary teamwork has been made in pancreatic surgery. Although many guidelines have been released at home and abroad,there are controversies in the differential diagnosis, operative indications, surgical procedure, and the follow-up strategies toward patients with PCN. There are also significant differences in the level of diagnosis and treatment of medical centers, which brings certain challenges to the standardized diagnosis and treatment of PCN. Based on the latest clinical guidelines and new developments in clinical researches, the authors summarize the controversies of different guidelines in the diagnosis, treatment and follow-up of PCN in order to further improve the standardization of the diagnosis and treatment.