Pancreatic cancer is one of the deadliest cancer types. Incidence rates are on the rise in the Western world, transforming it into one of the most common causes of cancer-related death. Pancreatic adenocarcinoma is the most frequently encountered type and diagnosis often occurs in an advanced stage, hence when curative treatment is no longer an option. Current management strategies are based on the tumour stage and resectability as well as patient characteristics, and should be discussed by a multidisciplinary tumour board. In patients with resectable disease, surgery followed by adjuvant therapy is the golden standard. Neoadjuvant strategies are currently gaining popularity, especially for borderline resectable disease. In the advanced setting, treatment with combination chemotherapy has only modestly improved overall survival. The field of personalised medicine is rapidly evolving and slowly trying to find its way into the classically defined treatment paradigm of pancreatic cancer. In this article, we aim to provide an overview of the current treatment options and highlight future developments.