Delayed gastric emptying (DGE) is a common complication following pancreatic resection affecting 8–40% of patients based on the type of surgery. It is defined by a validated grading system based on severity and clinical impact. Risk factors associated with increased incidence include postoperative complications and various preoperative risk factors. The association between surgical technique and DGE has been extensively studied in the literature with conflicting results. Current evidence suggests no difference in the incidence of DGE following a pylorus-preserving pancreatoduodenectomy (PpPD) vs. pylorus-resecting pancreatoduodenectomy (PrPD). The existing data suggest that antecolic reconstruction may be superior to retrocolic reconstruction in reducing DGE. Billroth II type and Roux-en-Y reconstruction have been shown to reduce rates of DGE compared to Billroth I type reconstruction for PpPD. Additionally, recent studies have shown that enhanced recovery protocols and individualized risk-stratification pathways appear to reduce DGE rates. Studies have recommended against routine use of nasogastric intubation and use of enteral feeding methods via nasojejunal feeding tubes or jejunostomy tubes.