Clinicopathological features of cystic neoplasms of the pancreas were studied in 38 patients of whom 22 had serous cystadenoma, 7 benign mucinous cystadenoma, 7 cystadenocarcinoma, and 2 solid and cystic tumour. Of the latter tumours, one was malignant. Sixteen patients (12 with serous cystadenoma) had previously or simultaneously non-pancreatic malignant disease, mostly of the urogenital tract. There was a female predominance of 29/9 in the series and median age differed between tumour types. Mean tumour sizes were similar in the different tumour types. Compared with the other tumours, serous cystadenomas were more frequently situated in the body or tail of the pancreas. Macroscopically, serous cystadenoma were often indistinguishable from pseudocysts, although the absence of previous pancreatitis, alcohol abuse, and gallstone disease favour the diagnosis of neoplasia. The malignant tumours rarely metastasized and showed a far better prognosis than ductal adenocarcinoma of the pancreas. Since serous cystadenoma occurs in old age (median 76 years), is often without symptoms, and is easily diagnosed histologically, a conservative surgical approach might be considered when symptoms are absent. All other tumours should be excised.