Palliation of cancer-related symptoms in pancreatic cancer is becoming increasingly important. The most common symptoms are biliary obstruction, duodenal obstruction, and abdominal pain. Recent advances in endoscopic techniques allow stents to be placed to relieve biliary and duodenal obstruction. In addition, there are several surgical options for palliation. As patients live longer with biliary stents, knowledge of management of partially occluded stents is becoming increasingly important. This chapter reviews the role of endoscopic and surgical techniques in palliation of pancreas cancer-related symptoms.