Objective：This study aims to analyze the postoperative progression pattern of intraductal papillary mucinous neoplasm（IPMN）and risk factors related. Methods：The clinical and follow-up data of 153 patients who received surgical resection and pathological confirmed of IPMN from 2010，March to 2019，December in the First Affiliated Hospital of Nanjing Medical University was retrospectively analyzed. According to the location of the progressive lesion，the progression patterns included：lesion growth at the pancreatic resection site，lesion growth in other parts of the pancreas，and distant metastasis. The proportion of each progress pattern，progress time and risk factors which affecting progress were analyzed. Results：Total 153 patients were included in the study group，107 patients were male（70%），median age was 66 years old（29-87 years old），59（39%）was branch duct IPMN（BD-IPMN），94（61%）was main duct IPMN（MD-IPMN）or mixed type IPMN（MT-IPMN）. There were 88 cases（58%）with low grade dysplasia（LGD），28 cases（18%）with high grade dysplasia（HGD），and 37 cases（24%）with intraductal papillary mucinous carcinoma（IPMC）. A total of 14 patients（9%）developed postoperative progression，including 5 patients（36%） with LGD and 9 patients with IPMC （64%）. Progressive patterns included growth at the resected site in 7 cases（50%），growth at other sites in the pancreas in 2 cases（14%），distant metastasis in 4 cases（29%），and growth at the resected site combined with distant metastasis in 1 case（7%）. Progression occurred within 5 years of surgery in 12 patients（86%）and 5 to 10 years after surgery in two patients（14%）. Univariate analysis suggested that postoperative pathology was a risk factor for progression（P < 0.001）. Conclusion：Although the prognosis of IPMN is good，there is still a high postoperative progression rate. It is necessary to conduct regular and long-term follow-up for patients with IPMN after surgery. Univariate analysis suggested that postoperative pathology was a risk factor affecting the progression. The progression pattern was mainly lesion growth at the resection site of the pancreas，suggesting that incomplete resection of the lesion during the first operation might be an important reason for the progression.