Objective To investigate the clinical value of ultrasound combined with multislice spiral CT (MSCT) in the diagnosis of pancreatic cancer. Methods The preoperative imaging data (ultrasound, MSCT) of 60 patients with pancreatic cancer confirmed by pathology in our hospital from January 2012 to January 2015 were retrospectively analyzed. The imaging findings of ultrasound and MSCT were observed and compared with pathological findings. The rates of confirmed diagnosis, missed diagnosis and misdignosis of ultrasound, MSCT alone and the combined detection of pancreatic cancer were analyzed. Results The rate of confirmed diagnosis of ultrasound, MSCT, ultrasound combined with MSCT in pancreatic cancer were 73.3%, 88.3% and 93.3%, respectively. The rate of confirmed diagnosis of ultrasound was significantly lower than that of MSCT and ultrasound combined with MSCT (P<0.05). Imaging findings of pancreatic cancer: for ultrasound, low echo or mixed echo masses, pancreas swelling, vague boundaries, irregular shape in the pancreas; For MSCT, routine plain scan mainly showed low density or equal density and enhanced scan of arterial phase mainly were not enhanced. The portal vein phase was medium inhomogeneous enhancement. Conclusion Ultrasound and multislice spiral CT in the diagnosis of pancreatic cancer have their own characteristics. The combined detection of the two has a high diagnostic rate of pancreatic cancer.