To improve surgical results after resection of pancreatic cancer, clinical trials with postoperative adjuvant treatment have been aggressively performed. In Europe, chemotherapy has been approved as a postoperative adjuvant therapy based on the results of the European Study Group for Pancreatic Cancer-1(ESPAC-1)trial published in 2004, and the Charité Onkologie (CONKO)-001 study published in 2007. In Japan, postoperative chemotherapy has been supported, as in Europe, under the influence of the results from the Japanese Study Group of Adjuvant Therapy for Pancreatic Cancer-02(JSAP-02)trial, published in 2009. In recent years, gemcitabine has been recognized as the first choice for adjuvant chemotherapy after surgery. Clinical trials with gemcitabine, fluorouracil, and molecular targeting agents are now under way.