Abstract: Pancreatic adenosquamous carcinoma is a rare exocrine pancreatic cancer, and surgical treatment is the only promising method in survival time extension and life quality enhancement. In July 2013, 1 patient with pancreatic adenosquamous carcinoma and sarcomatoid change was admitted to the Shaoxing People′s Hospital. A cauda pancreatis cystic nidus was detected by computed tomography 1 year ago, and no any other clinical symptoms were detected. The left upper quadrant of the patient was glutted and unwell, and the levels of CA19-9 and CA125 were 3 630 kU/L and 645 kU/L, respectively. The results of computed tomography and magnetic resonance imaging showed that a huge cystic and solid tumor was located between the cauda pancreatis, the stomach and the spleen; the tumor was mainly cystic and rooted in the tail of the pancreas; the spleen, stomach and surrounding tissues were infiltrated by the tumor. The results of postoperative pathological examination showed that the tumor was pancreatic adenocarcinoma with squamous epithelial differentiation and sarcomatoid change; the invasive squamous carcinoma dominated stomach wall, and the sarcomatoid change dominated spleen and lymph nodes with partial squamous epithelial differentiation and surrounding lymph nodes metastases. Although the surgical resection was complete and the 〖HJ〗postoperative thymosin injection and traditional Chinese medicine were implemented, tumor recurred at postoperative month 5, and the patient was dead due to cachexia and pernicious anemia at postoperative month 8. The prognosis of patients with pancreatic adenosquamous carcinoma is poor, early detection and surgery are key points for curative effect enhancement.