Objective: To review the diagnosis and management of serous cystadenoma of the pancreas. Methods: The clinical records of 22 patients with pancreatic serous cystoadenoma admitted from 2004 January to 2010 December were retrospectively analyzed. Results: Of the 22 patients, 4 were male and 18 were female, and their ages ranged from 16 to 74 (average of 47.0) years. Majority of patients were admitted for non-specific abdominal distension or pain, and some of them had no symptoms at all. The diagnotic sensitivity of ultrasound, CT and MRI for this disease was 86.3% (19/22), 93.8% (15/16) and 100% (12/12), respectively. All patients underwent surgical treatment and the diagnoses were validated by pathological examination. Of the patients, 5 cases underwent pancreatoduodenectomy, 1 case underwent duodenum-preserving pancreatic head resection, 2 cases underwent middle segment pancreatectomy, 3 cases underwent distal pancreatectomy, 5 cases underwent distal pancreatectomy and splenectomy, 2 cases underwent laparoscopic distal pancreatectomy and splenectomy, and 4 cases underwent pancreatic tumor enucleation. In the entire group, there was no perioperative death, whereas postoperative pancreatic fistula occurred in 5 cases, and bleeding of the pancreatic stump and delayed gastric emptying occurred in 1 case each. All these complications were resolved before the patients were discharged. All the patients were followed up for 10 months to 6 years and there was no recurrence. Conclusion: Pancreatic serous cystoadenoma is mainly seen in middle-aged and elderly women, and for this condition, ultrasound, CT and MRI examinations have high diagnostic value, and surgical resection is safe and effective treatment.