Pancreatic cancer is a devastating disease for the patient and presents challenging diagnostic and management problems for the physician. A range of serologic and radiologic studies are available for evaluation and staging of this disease. However, invasive studies, including laparotomy, are often necessary to establish the diagnosis and resectability. Despite advances in diagnostic technology that have shortened the interval between onset of symptoms and definitive treatment, no appreciable impact on survival has been demonstrated conclusively. Operative resection offers the only hope for cure, but fewer than 15 percent of patients have resectable disease at the time of diagnosis. Palliative therapy, whether operative or nonoperative, can be performed with low morbidity and provides significant relief of symptoms. Combined-modality treatment with chemotherapy and radiation therapy prolongs survival following curative resection.