Abstract: The special suppressive tumor immune microenvironment is a significant factor in the high postoperative recurrence rate and insensitivity to immunotherapy in pancreatic cancer. Tertiary lymphoid structures (TLSs) are pathologic ectopic lymphoid tissues composed of various immune cells, playing a crucial role in regulating adaptive anti‑tumor immune responses. The presence of TLSs in pancreatic cancer tissues signifies better prognosis and immune therapy response. Examining the quantity, location, maturity, and cellular components of TLSs in pancreatic cancer specimens helps predict prognosis and screen potential beneficiaries of immunotherapy. Exploring key factors inducing TLSs formation and elucidating the anti‑tumor immune mechanisms of TLSs may provide a new theoretical basis for enhancing the efficacy of pancreatic cancer immunotherapy. The authors summarize the clinical status and hot topics of TLSs in pancreatic cancer applications, and look forward to the research directions of TLSs in the field of pancreatic cancer.