With the popularity of imaging examination and the increase in average life expectancy, the detection rate of pancreatic cystic neoplasm (PCN) is also increasing.Different subtypes of PCN have different risks of malignancy, therefore, accurate stratification of the malignant potential is crucial for providing surveillance plans and making surgical decision.In recent years, many guidelines have identified several imaging features (cyst size, mural nodules, and main pancreatic duct diameter) as risk factors for PCN malignancy.However, the measurement standards for individual feature are not uniform and their diagnostic capabilities are limited; models that integrate multiple features perform poorly in diagnosis.This article reviews the value of imaging risk factors in PCN malignancy prediction and the application of radiomics and artificial intelligence, providing direction for further imaging research and improving the accuracy of preoperative PCN risk stratification.