We describe a case of a metacronous cerebellar metastasis from pancreatic adenocarcinoma occurred in a 67 years old male. Central nervous system metastases from pancreatic carcinoma are mostly autoptic findings. To our knowledge, this is the first case reported in literature of cerebellar metastasis from pancreatic cancer; furthermore, this case calls attention on vomit presentation that could be erroneously attributed to an abdominal relapse. Due to the increasing frequency of central nervous system metastases observed in recent years in other types of cancer, some authors speculate that this event could represent a consequence of the prolonged natural history as the result of improved survival.