Pancreatic cancer has a low surgical resection rate and a very poor prognosis. In recent years, with the emergence of new drugs, the diversification of treatment methods, the development of multidisciplinary diagnosis and treatment models, neoadjuvant treatment and translational treatment of pancreatic cancer have attracted widespread attention. This article systematically sorts out the clinical application of neoadjuvant therapy and translational therapy in pancreatic cancer, as well as the timing of surgery after translational therapy, and proposes to divide resectable pancreatic cancer into low-risk groups and high-risk groups. Patients in the low-risk groups are recommended to prioritize surgical resection. The high-risk groups and patients with borderline resectable pancreatic cancer have a lower rate of R0 resection. Neoadjuvant therapy can significantly increase the rate of R0 resection. For patients with unresectable pancreatic cancer, a comprehensive assessment should be made on whether conversion therapy can be performed, and radical surgery is feasible for some effective patients. However, there is no consensus on the selection of neoadjuvant treatment and translational treatment for pancreatic cancer, the treatment cycle, and postoperative adjuvant options. It is believed that with the emergence of highlevel evidence-based medicine, neoadjuvant therapy and conversion therapy will be more widely used in the treatment of pancreatic cancer.