Pancreatic cysts are being encountered frequently because of rapid advances in radiologic technology and an increased cross-sectional imaging demand. Management of pancreatic cystic tumors is challenging because most of them are asymptomatic; they are potentially malignant, and surgery has substantial morbidity and mortality. Endoscopic ultrasound (EUS)-guided fine-needle aspiration of pancreatic cystic tumors is accepted as a minimally invasive technique, which also enables injection of ablative agents into cysts under EUS guidance. In this review, the basic procedural steps and technical considerations of cyst ablation and their clinical issues including safety, feasibility, and therapeutic outcome will be summarized.