Endoscopic ultrasound-guided fine needle aspiration cytology/biopsy is now widely used to diagnose pancreatic tumors. The procedure was introduced to Mie University Hospital in 2006. A pathologist and cytotechnologist collaborate in the endoscopy room, and immediate on-site diagnosis is routinely performed in our hospital. If the pathologist is not able to come to the bed-side, telediagnosis is done using a digital camera attached to a smart phone. The authors emphasize that communication between physicians, cytotechnologists, and pathologists is very important. Therefore, the presence of pathologists in the endoscopy room promotes physicians' skills as well as the accuracy of this procedure.