While classification of pancreatic neoplasms has not evolved significantly since 2007, data related to the molecular underpinnings that characterize each type of neoplasm have grown exponentially in the past 15 years. The current multimodal study of pancreatic neoplasms has allowed a better understanding of tumor biology, more closely linking the morphologic findings with clinical outcomes and targeted treatment. The prognosis of conventional pancreatic ductal adenocarcinoma remains very poor, but some promise is on the horizon based on novel treatment approaches and the increase in earlier diagnosis. Furthermore, intensive study of other pancreatic neoplasms has led to a clearer recognition that each type has distinctive biology and behavior that is often not so highly aggressive. This sense of optimism may help drive a resurgence of interest in pancreatic pathology.