The incidence of intraductal papillary mucinous neoplasms (IPMNs) of the pancreas has been rising in the past 2 decades, driven mainly by the widespread use of cross-sectional imaging. IPMNs are intraductal mucin-producing neoplasms that involve the main pancreatic duct or its side branches and lack the ovarian stroma typically seen in mucinous cystic neoplasms. The International Association of Pancreatology released consensus guidelines in 2006 and 2012 providing clinical algorithms based on IPMN features and risk of malignancy. In this article, we review the different classifications of IPMNs, their natural history, and clinical management and address recent controversies in the literature.