A 19-yr-old woman developed pancreatic insufficiency and pericholangitis associated with ulcerative colitis. Recognized causes of pancreatic insufficiency were excluded. Pancreatic insufficiency has not previously been reported in patients with ulcerative colitis, although interstitial pancreatitis at postmortem examination and pancreatic duct abnormalities by endoscopic pancreatography have been described. Pancreatic insufficiency and ulcerative colitis may have occurred together by chance in this patient, but the time sequence and exclusion of known causes of pancreatitis suggest an association between these two conditions. The literature concerning pancreatic disease in ulcerative colitis is reviewed.