Background and aim: Accurate preoperative diagnosis of pancreatic cystic lesions is essential to avoid unnecessary major or whole pancreatectomy. Relying solely on radiologic imaging features for diagnosing pancreatic cystic lesions can be misleading, as up to 40% of serous and mucinous lesions are incorrectly classified as pseudocysts. Endoscopic ultrasound (EUS) has emerged as a valuable tool for the diagnosis and evaluation of pancreatic cystic lesions. The aim of this study is to evaluate the diagnostic accuracy of endoscopic ultrasound in distinguishing between malignant and non-malignant pancreatic cystic lesions. Methods: This retrospective study analyzed 80 patients with pan-creatic cystic lesions identified by CT and MRI who were referred for endoscopic ultrasound for further assessment. Results: Our results showed that validity of EUS in differ-rentiating pancreatic malignancy from benign yielding sensitivity of 93.7%, specificity of 87.5% and total accuracy of 91.2%. Kappa agreement between histopathology and EUS was (0.968). Conclusion: The diagnostic accuracy of EUS in discriminating malignant potential versus non-malignant potential pancreatic cystic lesions was found to be of high accuracy raising its importance in the differ-ential diagnosis and surveillance of PCLs.