We read with interest the American Gastroenterological Association (AGA) Institute Guidelines, and the accompanying AGA Technical Review, on the diagnosis and management of asymptomatic pancreatic cysts, published in the April edition of Gastroenterology.1,2 The authors are to be congratulated on the herculean task of synthesizing the literature pertaining to neoplastic cysts of the pancreas in an attempt to provide guidance. However, we are concerned that the guidelines are not evidence based, and that some of the recommendations within the guidelines are misleading and incorrect.