Abstract: The diversity of pancreatic diseases determines the diversity of treatments. Precision imaging diagnosis is a prerequisite for precision clinical treatment. Imaging diagnosis is related to the choice of different clinical treatments. Diseases which are easily misdiagnosed by imaging examinations will lead patients to miss the best treatment and time. Precision diagnosis and treatments require the combined efforts of radiologists and multidisciplinary team. Based on the relevant clinical experiences, the authors summarize the imaging findings, clinical manifestations and treatments of pancreatic diseases which are commonly misdiagnosed and treated with different methods in order to improve the comprehensive understanding of pancreatic diseases to the radiologists and clinicians and to guide treatment decision reasonably.