Background: The management of pancreatic intraductal papillary mucinous neoplasia (IPMN) is dependent on their risk of malignant progression to invasive IPMN. Recently a 5- point scoring system has been proposed as a useful clinical tool to predict the malignancy of IPMNs; however, this tool has not been validated. Here, we investigate the ability of the 5 point scoring system to predict malignancy in patients with IPMNs who had surgical resection of their IPMNs. Methods: A total of 179 patients underwent pancreatic resection for IPMN from 1998 to 2011 at our institute. Data was entered prospectively. Following review of scoring system from Shin et al. [4] (World J Surg 2010), primary data extracted from the database included the following information for each patient: age, presence of mural nodule, MPD dilation, CA19-9, history of pancreatitis, tumor size, duct communication (side, main, or mixed), and final pathology reports. This scoring system uses five independent variables: the presence of mural nodules, MPD diameter >6 mm, CA 19-9 >37 U/mL, history of pancreatitis, and age =60 years. One point was given to each variable. Validation of the scoring system was performed using a ROC analysis. Results: Records of 98 patients included all five variables. Analysis showed that a cut-off of 3 points had the highest discriminating power. The associated risk ratio (RR) was 3.13 (95% CI: 1.51-6.49) and could predict IPMN malignancy with a sensitivity of 73.2% and a specificity of 80.7% (AUC: 0.81, 95% CI: 0.73-0.89). Additional analysis performed on side-branch variant of IPMN and mixed type (71 cases) for the cut-off of 3 points also showed the highest discrimination in predicting malignancy in IPMN. The RR was 6.49 (95% CI: 2.41-17.7) with a sensitivity of 84.6% and specificity of 86.7% (AUC: 0.90, 95% CI: 0.82-0.96). Conclusion: The 5-point scoring system described by Shin et al. [4] was successfully validated and can be used to reliably predict malignancy in IPMN in both main branch and side/mixed cases of IPMN. This scoring system may assist clinicians in predicting malignancy in the preoperative patient with IPMN and is especially useful with the side branch and mixed variant.