Pancreatic cancer is an aggressive malignant gastrointestinal tumor,surgical resection offers the only chance of cure. Due to its anatomic and biological characters,early stage pancreatic cancer is usually clinically silent,80％-85％ of patients present with advanced unresectable disease. Furthermore,pancreatic cancer responds poorly to most radiochemotherapeutic agents.In this article,we discuss some clinical aspects including early diagnosis,preoperative systemic assessment,surgery and perioperartive adjuvant therapy,and we hope to find the challenges as well as strategies for pancreatic cancer in order to further improve the current level of diagnosis and treatment in China.