Liquid biopsy is a promising method of diagnostics in pancreatic cancer (PC). Concordance of mutational status between tumor tissue and circulating tumor DNA (ctDNA) and the prognostic significance of the latter have been actively studied in recent years but results are heterogeneous. We carried out a systematic review and meta-analyses to address these issues. PubMed, ASCO and ESMO databases were searched to identify studies that have been published until February 2020. Inclusion criteria for publications were the following: more than 10 participants enrolled in the study, presence of the data concerning concordance of mutations identified in paired tumor and blood samples; for articles on prognostic significance – presence of HR and 95% CI for PFS and OS. Random effects were used for analyses due to potential heterogeneity of the studies. Meta-analyses were performed using Review Manager (RevMan), version 5.3. 16 studies including 549 patients were enrolled to assess mutational status concordance. The data of these studies were significantly homogeneous (р=0.31, I2=12%). Our results showed that the mutational status of ctDNA and tumor tissue was significantly different (16%, HR 0.84, 95% CI 0.78-0.90, р< 0.00001). Analysis of ctDNA prognostic significance included 17 studies, 5 of which were dedicated to resectable PC. Meta-analysis of the studies evaluating the importance of ctDNA at any stage of disease showed that detection of ctDNA before treatment adversely affected OS (HR 2.21, 95% CI 1.35-3.33, р=0.001) (I2=84%, р< 0.00001). Presence of ctDNA both before and after surgery was a negative predictor of PFS (HR 2.32, 95% CI 1.54-3.5, р< 0.0001; I2=0%, р=0.47) and OS (HR 2.01, 95% CI 1.12-3.63, р=0.02; I2=51%, р=0.08). Patients with undetectable ctDNA after surgery also had better PFS (HR 3.06, 95% CI 1.63-5.76, р=0.0005; I2=45%, р=0.18) and OS (ОP 3.39, 95% CI 2.12-5.44, р< 0.00001; I2=0%, р=0.78) compared with patients with detectable ctDNA. The possible discordance of the mutational status between ctDNA and the primary tumor has been shown. The detection of ctDNA in the blood of patients was a negative prognostic factor in resectable and advanced PC.