Background: To define the possibilities of differential diagnostics of rare cystic pancreas lesions (RСPL). Methods: 117 patients with RСPL were examined (ultrasound, CT and MRI with bolus contrast enhancement) and treated. Morphology: intraduct papillary mucinous tumor (IPMN) – 35(30,0%), solid-pseudopapillar tumor (SPPT) – 26(22,2%), cystic form of duodenal dystrophy (CDD) – 52(44,4%), cystic teratoma (1(0,85%), cystic lymphangioma (1(0,85%), echinococcus cyst (2(1,7%). Results: IPMN: 57,1% male. Radiology criteria: advanced duct, fusiform with lesions of main pancreatic duct (MPD) or cystic cluster structures in bransh-ducts and mixed; seal duct/ducts walls; parietal papillary growths, there may be a single extended bransh-ducts and tumor masses around MPD. IPMN preoperative verification 80,0%. Priority - MRI. SPPT: 92,3% female. Radiology criteria: type 1: heterogeneous solid structure with a very small cystic inclusions, fluid-filled with a hemorrhagic component; type 2 and 3: cystic inclusions or cystic structure with a slightly pronounced parietal solid component. SPPT preoperative verification 46,1,%. Priority - MRI. CDD: 90,4% male. Radiology criteria: thickening of the duodenum wall with cystic formation, varying degrees of duodenal stenosis. CDD preoperative verification 96,2%. Conclusion: The knowledge of RСPL possible presence in the pancreas in combination with characteristic symptoms of disease allows to make the correct diagnosis. MRI should be preferred in the algorithm of the survey at suspicion of RСPL.