Background: Pancreatic cancer is one of the most aggressive cancer form and the fourth largest cause of cancer mortality. 5-year survival after diagnosis is 7% in Norway. 10% -15% of tumors are resectable which can lead to full recovery in some while in others it helps to provide prolonged survival and improved quality of life. Most cases of pancreatic cancer is unresectable at diagnosis as the cancer has metastasized and surgery provides no chance of cure . Adenocarcinoma of the head portion of the pancreas is the most common type that emanates from exocrine tissues and comprise 90% of all pancreatic cancers. Risk factors such as smoking, type II diabetes and chronic pancreatitis constitute for more ¼-third of the cases. The reason for the poor prognosis are either that the symptoms are usually detected at a later stage or non-specific symptoms. Curative treatment is surgery+ adjuvant therapy. Methods: I have reviewed studies concerning the effects of neoadjuvant therapy on resectable, borderline resectable and non-resectable pancreatic cancer to see if there is an increase in resection rates and survival percentages. Results: Resection rates is reduced after neoadjuvant in patients with resectable pancreatic cancer while survival is longer in those being resected. On the other hand, there is a significant increase in resection rates in patients with borderline/locally advanced pancreatic cancer. Survival is longer for the whole group while other studies indicate no difference with or without neoadjuvant. There is an increase in resection rates in patients with metastasis especially after neoadjuvant FOFIRINOX. However, there are advantages and disadvantages with neoadjuvant therapy such as progression of the disease and the risk of an initial resectable cancer becoming unresectable. Conclusion: The finding that there is a reduction in resection rates after neoadjuvant in resectable patients and longer survival in those being resected makes the clinical benefit of neoadjuvant therapy for this patient group unsure. On the other hand, the finding that a significant number of patients initially judged borderline resectable/unresectable had an increase in resection rates and to some degree longer survival suggests that these patients should be offered neoadjuvant therapy. Patients with metastasis also experience increase in resection rates after neoadjuvant FOLFIRINOX. Bigger randomized trials are needed to confirm this.