In the past decade there has been increasing focus on assessment of the quality of life (QoL) of patients with cancer. QoL is now a mandatory endpoint in many cancer clinical trials, particularly in interventions with palliative intent alone. Although QoL is difficult to define, a variety of specially designed and validated questionnaires has been developed to measure QoL in the clinical setting. In pancreatic cancer, assessment (QoL) is of paramount importance; however, little research has been conducted and until recently no disease-specific QoL questionnaire existed. In this review we consider the quality of life of patients with pancreatic cancer, with particular reference to the symptoms and psychosocial consequences of the disease. The literature is critically examined on the approaches to evaluation of QoL in previous pancreatic cancer clinical trials. We then describe the impact on QoL following both “curative” and palliative surgical interventions and medical treatment, including endoscopic palliation and chemotherapy for pancreatic cancer. In the European Organisation for Research and Treatment of Cancer (EORTC) the questionnaire specific for pancreatic cancer, the QLQ-PAN26, is discussed as a standardised and valid assessment of QoL in international clinical trials. Finally, recommendations are made for future QoL research in pancreatic cancer.