INTRODUCTION Various imaging modalities are used for the diagnosis and staging of pancreatic cancer. Abdominal ultrasonography is the most widely available method and usually the first -line diagnostic tool used in patients with suspicion of pancreatic carcinoma. OBJECTIVES The aim of the study was to assess the clinical value of abdominal ultrasonography used in a tertiary center for staging of pancreatic carcinoma. PATIENTS AND METHODS This prospective clinical trial included 454 consecutive patients with pancreatic cancer, who underwent a surgery between 2000 and 2012. The diagnostic accuracy of ultrasonography was established for each T category and lymph node involvement. Computed tomography and intraoperative staging of the pancreatic cancer were used as reference methods. RESULTS The diagnostic accuracy of ultrasonography in cancer staging according to T categories was 94.1% for T1, 95.7% for T2, 85.4% for T3, and 81.7% for T4 tumors. The diagnostic accuracy of abdominal ultrasonography in the diagnosis of lymph node metastasis and assessment of tumor resectability was 66.1% and 74.8%, respectively. CONCLUSIONS The results of our study summarize 12 years of our experience with abdominal ultrasonography in patients with pancreatic cancer and confirm that ultrasonography remains a valuable diagnostic modality in this patient group.