Pancreatic cancer is the thirteen leading most common malignancy, accounting for up to 2% of all malignancies. In majority of cases pancreatic cancer is diagnosed when local progression of the malignancy makes radical surgical treatment impossible. The extent of surgical treatment of tumors of the pancreatic head is planned on the basis of preoperative imaging studies and endoscopic studies and the final decision depends on intraoperative assessment of the lesion progression and results of cytological or histopathological examination of intraoperatively collected specimens. Fine needle aspiration biopsy (FNAB) is performed before possible resection of the tumor of the pancreatic head.The aim of the study was to compare results of FNAB with final histopathological assessment of collected specimen and survival of patients with negative cytological examination and patients in whom transduodenal fine needle aspiration biopsy confirmed the presence of cancer cells.Material and methods. This retrospective study involved 63 patients hospitalized due to tumor of the pancreatic head in Department of General, Gastroenterological and Endocrinological Surgery between 2000 and 2007. All patients underwent fine needle aspiration biopsy during the laparotomy. In some patients, an intraoperative decision was taken to proceed to core biopsy from suspected malignancy sites despite negative result of cytological examination. This analysis included only patients with evaluable material collected for cytological examination. Long-term results of treatment were obtained basing on clinical examination of patients who attended a follow-up visit and telephone survey conducted among patients and their families in the event of patients who did not attend a followup visit.Results. The longest overall survival of patients with positive cytological examination who underwent a palliative procedure was 10 months, while in patients who underwent radical treatment amounted to 2 years. Sensitivity of fine needle aspiration biopsy (FNAB) in our study was 85.7%Conclusions. FNAB is an indispensible part of diagnostic workup in the pancreatic cancer and cannot be omitted even in inoperable cancers confirmed by imaging studies. FNAB not only guides surgical treatment but also dictates adequate adjuvant and neoadjuvant systemic therapy - radio- and chemotherapy.