The natural history of pancreatic pseudocysts in pregnancy appears similar to that in nongravid patients. Hyperlipidemia is overrepresented as a cause of pancreatic pseudocysts in pregnancy, causing more cases than alcoholic and biliary pancreatitis combined. Seventy-five percent of cases of known parity was primaparous. While in some cases percutaneous or endoscopic drainage was performed antepartum, most patients were conservatively managed until delivery. Despite two cases of successful vaginal delivery, cesarian section may be preferable for large pseudocysts to avert rupture.