Advanced pancreatic cancer is a major cause of cancer-related death. However, if surgery achieves clear margins and negative lymph nodes, the prognosis for survival can be prolonged. Therefore, early diagnosis - as early as possible - is important for improving overall survival and quality of life in patients with pancreatic cancer. Because of higher imaging resolution near the pancreas through the gastroduodenal wall, endoscopic ultrasonography enables detection of subtle pancreatic abnormalities. In fact, many investigators have reported the high ability of EUS not only for detection of small lesions but also recognition of chronic pancreatitis, which is the risky status of pancreatic cancer. As a tool for early diagnosis of pancreatic cancer, EUS is a highly anticipated modality.