Objective To explore the added value of ¹⁸F-FDG PET/CT for preoperative evaluation of the distant metastasis of pancreatic cancer by the abdominal contrast-enhanced CT (CE-CT). Methods Data of abdominal CE-CT and ¹⁸F-FDG PET/CT of 51 patients with pancreatic cancer were retrospectively analyzed. The distant metastasis of pancreatic cancer was diagnosed by the CE-CT and CE-CT combined with ¹⁸F-FDG PET/CT. Results of pathological diagnosis or follow-up were adopted as the golden standard and the added value of ¹⁸F-FDG PET/CT was analyzed. Results The sensitivity, specificity, and accuracy of CE-CT combined with ¹⁸F-FDG PET/CT for diagnosing the distant metastasis of pancreatic cancer were 94.2% (33/35), 100% (16/16), and 96.1% (49/51). Compared to 71.4% (25/35), 100% (16/16), and 76.5% (41/51) of CE-CT, the differences of sensitivity and accuracy were statistically significant (χ²=6.43, P=0.011; χ²=6.04, P=0.014). A total of 26 patients were diagnosed of no distant metastasis by CE-CT, but 6 of them were diagnosed of liver metastasis (close to the liver capsule with diameter between 6.7-9.8 mm) and 2 of them were diagnosed of lung metastasis by CE-CT combined with ¹⁸F-FDG PET/CT. Another 25 patients were diagnosed of distant metastasis by CE-CT and confirmed by CE-CT combined with ¹⁸F-FDG PET/CT. Conclusion ¹⁸F-FDG PET/CT provides added value for patients who are diagnosed of pancreatic cancer with no distant metastasis by CE-CT, especially for patients with small liver lesion (diameter<1 cm) close to the liver capsular.