Abstract Diagnosing malignant pancreatic neoplasms presents a challenging task fraught with the possibility of diagnostic errors due to similarities with other pathologies such as pancreatitis, neuroendocrine tumors, and cystic formations. The key diagnostic method is contrast-enhanced multi-detector computed tomography, yet even this method has certain limitations that may affect diagnostic accuracy.Through the analysis of clinical cases, typical errors accompanied by visual characteristics that can be misleading in differential diagnosis have been identified. Hypodensity and tissue structure alterations, changes in ducts, or mass effect may be common features of both cancer and pancreatitis. Comparing visual signs with the clinical picture and employing additional methods aids in reaching a more precise diagnosis.It is important to note that rare pathologies such as serous oligocystic adenoma and intraductal papillary mucinous neoplasm may also pose additional challenges for accurate diagnosis due to their unusual characteristics on computed tomography scans.The conclusions of the study underscore the importance of a multimodal approach to diagnosing malignant pancreatic neoplasms, including the use of various imaging methods to ensure an accurate diagnosis and the selection of the most appropriate treatment strategy