Aims: Our purpose is to assess usefulness of contrast-enhanced power Doppler EUS (CE-EUS) for depiction and differential diagnosis of pancreatic tumors, as compared with contrast-enhanced harmonic US (CE-US) and contrast-enhanced CT (CE-CT). Subjects and methods: Consecutive 119 patients with suspicious pancreatic tumors received CE-CT, CE-EUS and CE-US. Coded phase-inversion harmonic mode (GE Logiq 9) which depicts signals from bubbles in fine vessels was used for CE-US. Power Doppler mode was used for CE-EUS (OLYMPUS GF-UC240P-AL5). Levovist was employed as the ultrasound contrast agent for CE-US and CE-EUS. CE-CT was imaged 30 and 60 seconds after the injection of contrast media. Sensitivities in depicting tumors and in differetiating ductal carcinomas from the other tumors were compared between the 3 modalities. Results: When hypovascular nodules relative to their surrounding tissue were defined as ductal carcinomas, the sensitivity on CE-EUS (69%) was significantly lower than those on CE-CT (82%) and CE-US (88%). However, values for sensitivity in depicting small pancreatic tumors of 2cm or less on CE-US (91%) and EUS (95%) were significantly higher than that on CE-CT (56%). Concerning to those small tumors, the values for sensitivity in differentiating ductal carcinomas from the other tumors were 40%, 73% and 67% on CE-CT, CE-US and CE-EUS, respectively. EUS depicted 7 of 9 ductal carcinomas that CE-CT failed to depict, 5 of which were hypovascular on CE-EUS. Conclusion: Although CE-EUS has limitation in differentiating pancreatic tumors due to artifact such as blooming and overpainting, it may be useful for differential diagnosis of small nodules of the pancreas which the other modalities failed to depict. The invention of the technology of contrast-enhanced harmonic EUS would further improve the abilities in depicting and differentiating small tumors.