<b><i>Introduction:</i></b> This study aimed to determine the preoperative clinicophysiological and postoperative clinicopathological predictors of malignancy in patients with intraductal papillary mucinous neoplasm (IPMN). <b><i>Methods:</i></b> This was a retrospective observational study. We included 121 patients (73 men and 48 women; mean age: 68.7 years) who had undergone pancreatic resection for IPMN between 2007 and 2018. These patients were grouped into invasive carcinoma (IPMN-INV, <i>N</i> = 21) and low/high-grade IPMN (IPMN-LG/HG, <i>N</i> = 100) groups. Univariate and multivariate analyses of clinicophysiological parameters were carried out. These parameters were also compared between the IPMN-INV/HG (<i>N</i> = 53) and IPMN-LG (<i>N</i> = 68) groups. Survival analyses according to macroscopic type and IPMN subtypes were performed. <b><i>Results:</i></b> On univariate analysis, age (<i>p</i> = 0.038), carbohydrate antigen (CA) 19-9 (<i>p</i> < 0.001), IPMN macroscopic type (<i>p</i> = 0.001), IPMN subtype (<i>p</i> < 0.001), pancreatic duct diameter (<i>p</i> < 0.001), and mural nodule (<i>p</i> = 0.042), between IPMN-INV and IPMN-LG/HG were found to be significant prognostic factors of malignancy. CA 19-9 was found to be an independent prognostic factor of IPMN malignancy on multivariate analysis (<i>p</i> = 0.035). The 1-, 3-, and 5-year overall survival (OS) rates of the IPMN-INV and IPMN-LG/HG groups were 94.4/100%, 94.4/100%, and 67.2/100%, respectively. The OS rate in the IPMN-LG/HG group was significantly higher than that in the IPMN-INV group (<i>p</i> < 0.001). On univariate analysis, platelet (<i>p</i> = 0.043), CA 19-9 (<i>p</i> = 0.039), prognostic nutritional index (<i>p</i> = 0.034), platelet/lymphocyte ratio (<i>p</i> = 0.01), IPMN macroscopic type (<i>p</i> < 0.001), IPMN subtype (<i>p</i> < 0.001), pancreatic duct diameter (<i>p</i> = 0.036), and mural nodule (<i>p</i> = 0.032) between IPMN-INV/HG and IPMN-LG were found to be significant prognostic factors of malignancy. On multivariate analysis, CA 19-9 was found to be an independent prognostic factor (<i>p</i> = 0.042) between IPMN-INV/HG and IPMN-LG of malignancy. The 1-, 3-, and 5-year OS rates of the IPMN-INV/HG and IPMN-LG groups were 97.9/100%, 97.9/100%, and 82.6/100%, respectively. The OS rate was significantly higher in the IPMN-LG group than in the IPMN-INV/HG group (<i>p</i> = 0.03). No significant differences in survival were observed in patients with macroscopic tumors (<i>p</i>= 0.544). <b><i>Conclusion:</i></b> CA 19-9 is an independent invasive malignancy predictor of IPMN.