The aim of this study was to evaluate the endoscopic retrograde pancreatographic (ERP) findings in respect of alcohol intake. Two hundred eleven patients consecutively submitted to ERP for upper abdominal symptomatology, with suspected pancreatic disease (SPD; 79 patients) or without (NSPD; 132 subjects), were classified in 3 groups of different ethanol intake: 1 (0-40 g/day), 2 (41-80 g/day), 3 (more than 80 g/day). The following conclusions could be drawn: (1) the frequency of ERP changes increases with the increase of alcohol intake both in SPD (34.6-63.8%) and NSPD (8.2-29.8%); (2) the frequency of pancreatic cancer was not related to alcohol intake, but in NSPD it was about 2-fold that in SPD: 12/132 (9.1%) vs 4/79 (5.06%); (3) a pancreatic morphological assessment, by means of ERP or other imaging techniques, should be performed in every subject with upper abdominal pain of unknown origin both in alcoholics (for the high incidence of chronic pancreatitis) and in non-alcoholics (for the risk of pancreatic cancer, which approximates 10%).