Pancreatic ductal adenocarcinoma (PDAC) is a rare but deadly cancer, with approximately 60,430 new cases expected in the US in 2021. The incidence of PDAC is increasing, and it is projected to become the second-leading cause of cancer-related mortality by 2030. Most patients present with locally advanced or metastatic disease at diagnosis, and effective screening methods are lacking. A multidisciplinary approach is recommended for management, including surgery, chemotherapy, and radiation therapy. For resectable disease, surgery followed by adjuvant chemotherapy with FOLFIRINOX is the standard approach, with a median overall survival of 54.4 months. For locally advanced and unresectable disease, systemic therapy followed by radiation is an option. In advanced PDAC, multiagent chemotherapy regimens, including FOLFIRINOX, gemcitabine/nab-paclitaxel, and nanoliposomal irinotecan/fluorouracil, have shown modest survival benefits. Germline testing for *BRCA* pathogenic variants is recommended for all patients, as olaparib, a poly (ADP-ribose) polymerase inhibitor, improves progression-free survival in this subset. The tumor microenvironment plays a crucial role in PDAC, and immune checkpoint inhibitors have shown limited efficacy. Novel therapies, including combination strategies and targeted agents, are under investigation. Supportive care and symptom management are essential components of patient care.Pancreatic ductal adenocarcinoma (PDAC) is a rare but deadly cancer, with approximately 60,430 new cases expected in the US in 2021. The incidence of PDAC is increasing, and it is projected to become the second-leading cause of cancer-related mortality by 2030. Most patients present with locally advanced or metastatic disease at diagnosis, and effective screening methods are lacking. A multidisciplinary approach is recommended for management, including surgery, chemotherapy, and radiation therapy. For resectable disease, surgery followed by adjuvant chemotherapy with FOLFIRINOX is the standard approach, with a median overall survival of 54.4 months. For locally advanced and unresectable disease, systemic therapy followed by radiation is an option. In advanced PDAC, multiagent chemotherapy regimens, including FOLFIRINOX, gemcitabine/nab-paclitaxel, and nanoliposomal irinotecan/fluorouracil, have shown modest survival benefits. Germline testing for *BRCA* pathogenic variants is recommended for all patients, as olaparib, a poly (ADP-ribose) polymerase inhibitor, improves progression-free survival in this subset. The tumor microenvironment plays a crucial role in PDAC, and immune checkpoint inhibitors have shown limited efficacy. Novel therapies, including combination strategies and targeted agents, are under investigation. Supportive care and symptom management are essential components of patient care.