Laparoscopic cystgastrostomy offers the benefits of a minimally invasive procedure while providing effective drainage for pancreatic pseudocysts. The lesser sac approach to laparoscopic cystgastrostomy provides adequate working space with excellent visualization. This assures meticulous hemostasis, debridement of the cyst, and wide internal drainage of the pancreatic pseudocyst. Additionally, the laparoscopic approach to this difficult problem can be augmented by other minimally invasive therapies. This video outlines the management of a patient with a pancreatic pseudocyst and concomitant splenic vein thrombosis treated with preoperative splenic embolization and laparoscopic cystgastrostomy via the lesser sac approach.