Abstract: Pancreatic cancer is a highly lethal malignant tumor that is difficult to diagnose in its early stages, and its effective treatment remains a significant challenge in clinical practice. Recently, radiolabeled fibroblast activation protein inhibitor (FAPI) as molecular probes have emerged as a focal point in pancreatic cancer diagnosis and treatment research. Its uptake in pancreatic cancer cells is significantly higher than in normal tissue cells, exhibiting an excellent tumor-to-background ratio, which facilitates accurate imaging and diagnosis of both primary and metastatic pancreatic cancer lesions, thereby providing more information for the formulation of subsequent treatment plans. Additionally, radiolabeled FAPI has pioneered novel approaches in the treatment of pancreatic cancer. Here, the author reviews the research progress of FAPI in the diagnosis and treatment of pancreatic cancer, with the aim of promoting the application of nuclear medicine in the diagnosis and treatment of pancreatic cancer.