Objective <p>This study was designed to investigate the incidence of postoperative sarcopenia in patients with pancreatic cancer and to analyse the related influencing factors.</p> Methods <p>This prospective cohort study included 265 pancreatic cancer patients who underwent radical surgery at Ruijin Hospital Affiliated with Shanghai Jiao Tong University School of Medicine from September 2023 to January 2024 and determined the incidence of postoperative sarcopenia in pancreatic cancer patients. Multivariate logistic regression analysis was used to identify factors associated with postoperative sarcopenia.</p> Results <p>The incidence of postoperative sarcopenia among 265 pancreatic cancer patients was 46.04%. Multivariate logistic regression analysis identified the following independent risk factors: age-adjusted Charlson Comorbidity Index (aCCI) score (odds ratio [OR] = 1.34, 95% confidence interval [CI] 1.04–1.72); preoperative nutritional risk assessed by Nutritional Risk Screening 2002 (NRS2002) (OR = 2.15, 95% CI 1.13–4.11); body mass index at admission (OR = 4.06, 95% CI 2.32–7.09); and body fat percentage 2 weeks postoperatively (OR = 6.07, 95% CI 2.73–13.49).</p> Conclusions <p>This study reveals the high incidence of postoperative sarcopenia in pancreatic cancer patients and identifies key influencing factors, which may help to improve clinical management and patient outcomes.</p>