The therapeutic tactics for pancreatic pseudocysts have changed dramatically over the past decade. Currently, due to the rapid development of minimally invasive technologies, the frequency of their use in the treatment of patients with pseudocysts has become widespread, displacing traditional methods of surgical treatment. Nevertheless, surgical treatment of a pseudocyst is justified when other methods of treatment have been ineffective, namely in the case of recurrence of the pseudocyst, with suspected cystic neoplasia of the pancreas, the presence of stenosis of the common bile duct or duodenum, as well as with complicated cysts. The purpose of this article is a literature review of methods and approaches to the surgical treatment of pancreatic pseudocysts, as well as the treatment of vascular complications in this pathology.