|Intraductal papillary mucinous neoplasm (IPMN) is a premalignant pancreatic entity. This neoplasm is often multifocal. Early surgical resection is the treatment of choice to avoid malignant transformation when predictive factors for malignancy are present. The extent of resection required for adequate treatment of IPMN of the pancreas is still controversial. We had 260 cases with diagnosed IPMN and 68 patients underwent operation between 1999 and 2015. Among them, 29 cases (11 males and 18 females) with malignant IPMN and received operations. All the patients were found to have malignant changes after tumors were resected, only one patient combined with pancreatic ductal adenocarcinoma in his resected pancreatic tissue. Among them, 15 were invasive types, 4 were borderline type and 3 were non-invasive type. The most common recurrent site after operation was the resectional margin of pancreas. The one, three and five years survival was 88.9%, 68.7% and 53.6%. The median overall survival time is 60.3 months. The outcome of patients with malignant IPMN is significantly better than the patients with pancreatic ductal adenocarcinoma. Since patients with IPMN of the pancreas are at risk of developing recurrent IPMN and pancreatic ductal adenocarcinoma in the remnant pancreas and extra-pancreatic malignancies, early recognition, treatment and systemic surveillance are of great importance.