Simple SummaryThe management of pancreatic lesions and especially of pancreatic cancer remains a diagnostic and therapeutic challenge given their poor overall prognoses. This review aims to summarize the available evidence on the role of endoscopic ultrasound regarding diagnosis, staging, and treatment of pancreatic lesions. Moreover, it highlights potential future research opportunities that could lead to improved patient outcomes.AbstractEndoscopic ultrasound (EUS) plays a crucial role in the diagnosis of both solid and cystic pancreatic lesions and in the staging of patients with pancreatic cancer through its use for tissue and fluid sampling. Additionally, in cases of precancerous lesions, EUS-guided therapy can also be provided. This review aims to describe the most recent developments regarding the role of EUS in the diagnosis and staging of pancreatic lesions. Moreover, complementary EUS imaging modalities, the role of artificial intelligence, new devices, and modalities for tissue acquisition, and techniques for EUS-guided treatment are discussed.