Background/Aims Pancreatic cancer patients having acute pancreatitis (AP) on presentation is rare and managing such patients can be challenging. Here we present our experience with management of such patients comparing them with those without pancreatitis Methods Seventeen patients who presented as pancreatic/peri ampullary cancer with associated acute pancreatitis (PCAP group) were analyzed and compared with 85 matched pancreatic cancer patients without AP (PC group), with respect to intra operative and postoperative outcomes Results Out of 17 patients, 10 had mild, 4 had intermediate and 3 had severe pancreatitis (SAP). The median duration between last episode of acute pancreatitis and surgery was 75 days (range 30, 237 days). Six patients had endoscopic retrograde cholangiopancreatography induced pancreatitis, six had obstructive pancreatitis, one had stone disease, and one had pancreatic divisum and for 3 cases, cause was not known. When compared to PC group, the overall morbidity (88.2 vs 58.8%, p value- 0.02), major morbidity (clavein grade IIIa or higher) (52.9% vs 27.1%, p -0.036) and clinically relevant post operative pancreatic fistula (CR-POPF) (47.1% vs 15.3%, p value- 0.003) were significantly higher in PCAP. Patients with SAP had significantly higher delay in surgery (206 vs 69 days, p -0.0001), more CR-POPF (100 vs 30.8%, p-0.01) and major morbidity (100% vs 38.5%, p-0.03) as compared to mid/intermediate pancreatitis. Conclusions PCAP patients have significantly high post operative morbidity and CR-POPF than those without pancreatitis following surgery. Amongst PCAP, SAP patients have significantly higher morbidity as compared to those with mild or intermediate pancreatitis