Background/aims: Management of pancreatic pseudocysts can be challenging. Endosonography-guided drainage of the pseudocysts is an important treatment modality. In this study, we evaluated the results of endosonography-guided transmural endoscopic drainage of these lesions. Materials and Methods: We performed drainage of the pancreatic pseudocysts through the stomach or duodenum using a linear endosonography device. The procedure steps were as follows: Determination of the best location for needle insertion, puncture of the cyst, guide insertion, creation of a window between the cyst and stomach lumen using a cystotome, and finally insertion of a double pigtail catheter. Results: The procedure was applied to 12 patients (8 males, 4 females, mean age: 51 +/- 15.6 years), with success achieved in 10 patients (83%), defined as complete disappearance of the cyst. The mean cyst diameter was 9 cm (range: 6-12 cm). There was only one complication (8%), as an intraabdominal abscess with an uncomplicated course after surgical drainage. Conclusions: Endosonography-guided drainage is an effective and safe method for the management of pancreatic pseudocysts.