Neoadjuvant therapy for pancreatic cancer is the treatment of pancreatic cancer patients with radiotherapy prior to radical pancreatic cancer surgery to improve prognosis. Whether patients with resectable pancreatic cancer should undergo neoadjuvant therapy remains highly controversial. Although some studies have shown that neoadjuvant therapy is expected to improve the complete resection rate and reduce the lymph node positivity rate of patients with resectable pancreatic cancer, the sample size is generally limited and the quality of the studies is not high. Currently, domestic and international guidelines advocate neoadjuvant therapy for patients with resectable pancreatic cancer who have a clear pathologic diagnosis and a combination of high-risk factors. Known high-risk factors include significant increase in CA19-9, large tumor size, regional lymph node enlargement suspected of metastasis, significant weight loss and accompanied by obvious pain. There is no standardized regimen for neoadjuvant treatment of resectable pancreatic cancer, and multi-agent combination regimens such as modified FOLFIRINOX or albumin-paclitaxel combined with gemcitabine are recommended for patients with good physical status. The significance of radiotherapy in the neoadjuvant treatment of resectable pancreatic cancer is not supported by high-quality studies, and radiotherapy can be received according to the specific circumstances and medical advice. During the treatment period, closely monitor the trend of tumor indicators and the results of imaging evaluation, pay attention to the control of serious adverse reactions and nutritional support therapy. Surgical intervention can be performed in time for patients with poor results of neoadjuvant therapy. According to domestic guidelines, neoadjuvant therapy is recommended for patients with resectable pancreatic cancer with high risk factors. If pancreatic cancer is suspected or diagnosed, it is recommended to go to regular hospitals for comprehensive assessment of the disease and follow the doctor’s instructions to avoid delaying the disease.