Pancreatic cancer is one of the most lethal cancers in the western world. The authors review the different chemotherapeutic regimens for the palliative approach of this disease. 5-fluorouracil has been the only drug with some efficacy for a longtime. Recently a clinical benefit has been obtained with gemcitabine. Polychemotherapy regimens based on gemcitabine, 5-fluorouracil, cisplatin and/or epirubicin have been administered in clinical phase II trials. The superiority of polychemotherapy in terms of palliative benefits or survival is uncertain. Palliative care remains an important issue.