During the last decade, great progress has been made in minimally invasive endoscopic techniques. For pancreatic pseudocysts (PPCs),endoscopic drainage has become the first-line therapeutic option. Recent advances in therapeutic endoscopic ultrasound (EUS)-relatedtechniques have focused on EUS-guided transmural drainage, which is now replacing the conventional endoscopy-guided transmuraldrainage. While transmural drainage is usually performed using multiple plastic stents with or without a nasocystic drain, fully coveredself-expandable metal stents are now being used with increasing frequency. In this review, we discuss some of the controversies related tothe endoscopic drainage of PPCs.