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INTRODUCTION To discuss the current evidence about radiolabeled-FAPI in patients affected by pancreatic cancer by underlying the advantages, disadvantages, and the future perspectives also in the theragnostic field. AREAS COVERED A literature search up until February 2023 was performed in PubMed, EBSCO, and EMBASE databases. Clinical reports, conference abstracts, editorials and letters-to-the-editor were excluded. The results were presented according to the PRISMA guidelines. The quality of studies was evaluated by using the Critical Appraisal Skill Program checklist. EXPERT OPINION From the initial 139 studies, 21 papers were selected for the final analysis. Ten papers were relative to FAPI-uptake in health/benign/malignant pancreas, 8 studies were focalized on the utility of radiolabeled-FAPI for the identification of premalignant and malignant pancreatic lesions and only 3 papers were relative to the theragnostic approach. Only 2 papers enrolled exclusively patients with pancreatic cancer undergoing FAPI-PET. In total, 55 patients underwent FAPI-PET for the identification of the suspicious mass/primary tumor (n=43) and recurrent disease (n=12). In both the studies, FAPI-PET detected more lesions than 2-[18F]FDG. Preliminary data about the FAPI-based theragnostic approach in patients with pancreatic cancer (n=9 patients, totally) are now available. Radiolabeled-FAPI is a promising agent for the identification of pancreatic malignant lesions, but further prospective studies are still necessary.