Pancreatic cancer is an extremely life-threatening neoplasm with a case-fatality rate approaching 100%. Smoking is the major known risk factor for this cancer, explaining 19% of all cases. The nutrition and food consumption patterns play other important roles in the etiology of pancreatic cancer, explaining 35% of all cases. Epidemiological evidences on the relationship between nutrition and pancreatic cancer found consistently positive associations between the intakes of meat, carbohydrates, and dietary cholesterol and pancreatic cancer. Consistent inverse relationships with fruit and vegetable intakes and, in particular, with fiber and vitamin C, have also been noted. Many inherited germline mutations increase the risk of pancreatic cancer. In addition, several common polymorphisms in genes that associated with metabolism of environmental carcinogens, DNA repair and folate metabolism may alter the risk of pancreatic cancer. Interaction between genes and environmental factors may contribute to the risk of pancreatic cancer.