We report the case of a 24-year-old patient with abdominal discomfort and weight loss. On imaging, a large unilocular cystic lesion originating from the pancreatic body and tail was seen. Endoscopic fine needle aspiration revealed a slightly elevated lipase, suggesting a connection with the pancreatic duct. Furthermore, the liquid appeared chylous, and markedly elevated triglycerides were noted. A transgastric drainage and biopsies of the cyst wall were performed. The diagnosis of a pancreatic cystic lymphangioma was made. Our patient was successfully managed conservatively by an echoendoscopic transgastric drainage.