Pancreatic cancer patients do not necessarily need puncture pathology before chemotherapy, which needs to be judged according to the situation. Pancreatic cancer is a malignant tumor of the digestive tract with insidious onset, rapid progression, and extremely poor therapeutic effect and prognosis. Pancreatic cancer has an insidious onset, early diagnosis is difficult, and most of the patients are already in the middle or late stage when they are diagnosed. Some pancreatic cancer patients need to determine the nature and stage of the tumor, immunohistochemistry, and evaluate the effect of treatment before chemotherapy, so they need to undergo puncture biopsy. However, it is mostly used for advanced stage patients and patients with abnormalities on follow-up. In addition, puncture pathology and placement of tubes to reduce yellowness are invasive operations with potential risks of bleeding, cholangitis, pancreatic fistula and tumor dissemination. Patients with locally progressive or metastatic pancreatic cancer usually require chemotherapy, which mostly needs to be judged based on the genetic profile, and tests such as genetic testing and immunohistochemistry can be performed, while pathological puncture biopsy can help in the relevant assessment. Puncture biopsy pathology examination is important for the treatment of pancreatic cancer, but not all patients need to be performed. If pancreatic cancer is diagnosed, it is recommended to go to regular hospitals for comprehensive assessment of the condition and follow the doctor’s instructions to cooperate with the treatment to avoid delay.