Adenosquamous carcinoma (ASC) of the pancreas is a rare subtype of pancreatic ductal adenocarcinoma(PDAC).Herein we report a pancreatic ASC co-existing with mucinous cystadenoma.Four years ago, a 72-year-old man was admitted to our hospital for his left inguinal hernia.Because his serum CA199 level was elevated in pre-operative studies, abdominal CT was performed and showed multiple cysts in pancreatic tail and suspicious mass in pancreatic head.We had follow-ups on the patient for four years.The patient s current presentation was progressive jaundice and abdominal CT revealed enlarged suspicious mass in pancreatic head.He underwent a total pancreatectomy and splenectomy.Histologically, the tumor in pancreatic head was ASC and the multiple cysts were mucinous cystadenoma.The patient didn t receive chemotherapy and has survived without evidence of recurrence for one year.