Pancreatic cancer is a gastrointestinal neoplastic disease with one of the worst prognoses. Despite aggressive surgical treatment with curative intent followed by adjuvant therapy, survival in these patients continues to be low. With the acquisition of new knowledge on imaging studies as well as diagnostic and therapeutic procedures in specialized centers, postoperative morbidity and mortality have decreased. In this chapter we will summarise pancreatic cancer with emphasis on studies of preoperative images, surgical treatment alternatives, and adjuvant therapy based on the evidence from several systematic reviews published in the literature.