Pancreatic cancer is the 5th leading cause of death from cancer, and the 11th most common cancer in the United States. The incidence of chronic pancreatitis (CP) varies between 4 and 14/100000 worldwide; additionally, patients with CP carry a 13.3-fold higher risk for developing pancreatic ductal adenocarcinoma. The most common symptom of CP is abdominal pain, with other symptoms such as exocrine pancreatic insufficiency and diabetes developing at highly variable rates. CP is most caused by toxins such as alcohol or tobacco, genetic polymorphisms, and recurrent attacks of acute pancreatitis, although no history of acute pancreatitis is seen in many affected patients. On the other hand, CP sometimes may present as a solid mass, mimicking ductal adenocarcinoma of the pancreas (PDAC). Misdiagnosis of MF-CP as focal pancreatic malignancy results in unnecessary surgical treatment, and misdiagnosis of PC as focal pancreatitis may delay necessary surgical intervention. The imaging diagnosis is not always simple and immediate, so in addition to CT and MRI, endosonography or invasive procedures may help make the correct approach.