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ObjectivePancreatic cancer is a deadly disease that may initially present as acute pancreatitis. This study aimed to examine the survival and outcomes of patients with pancreatic cancer presenting with acute pancreatitis.MethodsA retrospective review was conducted of alcohol-abstinent adult patients diagnosed with pancreatic cancer between February 2002 and February 2024 at a single tertiary care center. Patients with and without acute pancreatitis were compared with respect to clinical characteristics, tumor features, management strategies, and outcomes.ResultsA total of 284 patients were diagnosed with pancreatic cancer during the study period, of whom 84 met the inclusion criteria. Among these, 24 presented with acute pancreatitis. Sixty control patients without acute pancreatitis were matched for comparison. There were no significant differences between the groups in terms of demographics or comorbidities. Tumor stage, location, and histological subtype were also comparable. Acute pancreatitis was not associated with improved survival (p = 0.252). Patients in the acute pancreatitis group experienced significantly longer hospital stays (p = 0.044) and had a higher rate of sudden cardiac arrest (p = 0.032).ConclusionThe presence of acute pancreatitis in patients with pancreatic cancer is not associated with earlier diagnosis or improved survival outcomes. Although acute pancreatitis may lead to earlier clinical evaluation, it does not confer a prognostic advantage. Further studies are needed to clarify the clinical significance of acute pancreatitis in pancreatic cancer.