Pancreatic adenocarcinoma remains one of the most devastating malignancies to be managed by surgical oncologists. Herein, we provide a fellowship-level board review which summarizes essential components of the disease. This work provides a succinct and evidence-based review of disease workup, assessment of surgical candidacy, operative approaches, and multimodal approaches to treatment. The trainee is provided with key insights into the diagnostic value of commonly used imaging modalities and approaches to obtaining a pathologic specimen. Likewise, up-to-date evidence regarding prognostication and monitoring of tumor marker CA 19-9 is included. Must-know steps and considerations to the pancreaticoduodenectomy are outlined. This includes common surgical pitfalls and pancreas-specific postoperative complications. Additionally landmark trials for administration of multimodal treatment in the neoadjuvant and adjuvant setting as well as for patients with unresectable and metastatic disease are reviewed. Management of pancreatic cancer in special populations such as elderly patients and those with specific pathologic variants is reviewed. This chapter offers a broad-sweeping summary of pancreatic cancer and standard of care management which primes surgical oncology fellows for success in board examinations and clinical practice.