BACKGROUND Pancreatic cancer is generally in its advanced stage when symptoms of the disease develop and the diagnosis is established. Although an increase of the disease has been evident, an early diagnosis has still remained a problem. Ultrasonographic diagnostics in patients with abdominal troubles can classify abdominal changes as unechogenic-hypoechogenic and-iso-hyperechogenic circumscribed lesions. Of course, it cannot immediately differentiate between benign and malignant ones. It is by directed aspiration biopsy that either of them can be confirmed or excluded. METHODS In our series we examined 58 patients with a pancreas disorder. Ultrasonography verified a focal change in one part of the pancreas suspected of a tumor in 52 patients who were all submitted to a directed ultrasound guided aspiration biopsy. RESULTS Out of 58 examined patients tumor mass in the region of pancreas was found in 52 patients. Thirty-three patients were diagnosed with cancer, while 19 patients were with benign lesions--pancreatitis or cysts. Positive cytologic findings were confirmed in case of 41 patients. Method sensitivity was 88%. Moreover, we have achieved a great accuracy in suspecting a malignancy of the pancreas on the basis of additional, indirect symptoms, even when a tumorous lesion of the pancreas was not observed by ultrasonography. Method accuracy was 89%. CONCLUSIONS A fine-needle ultrasound guided biopsy is an efficient, relatively inexpensive technique which facilitates the diagnosis of cancer and contributes to a faster differential diagnosis of focal pancreatic lesions. Authors report diverse results and efficiency of the method. False-negative findings, i.e. a finding is negative despite the presence of cancer, are obtained in a diverse but a small percentage and due to different reasons. Nevertheless, this method is exceptionally safe. CONCLUSIONS Ultrasonographic diagnostics has been recognised as a valuable method in diagnosing lesions of the biliary tract and organs and blood vessels in the vicinity of the pancreas involved by a carcinoma. In a high percentage of the examined patients the intervention was successfully performed and a malignant or benign etiology of the change seen on ultrasonography was confirmed.