The spectrum of diagnostic procedures in patients with pancreatic malignancies today includes the patient's report and history, laboratory parameters, and modern techniques ranging from ERCP, EUS, CT, angiography, MRCP, and PET to molecular biology and parameters such as the cytological detection of ki-ras mutations. Anamnesis, laboratory parameters, tumor markers, ultrasound investigation, and ERCP are the relevant procedures for establishing the basic diagnosis of a pancreatic malignancy. MRCP will replace ERCP in most cases in future. EUS shows the highest accuracy in the diagnosis of vascular involvement by a pancreatic tumor.