Abstract: Pancreatic invasive ductal adenocarcinoma (PDAC) is characterized by an insidious onset, high invasiveness, poor prognosis, and high mortality rate. It is often difficult to detect in the early stages, and most are diagnosed at an advanced stage, with a five-year survival rate as low as 10%. Early diagnosis of PDAC is important for improving patient prognosis and reducing mortality. However, due to the non-specific symptoms of pancreatic cancer and the lack of reliable early biomarkers, early diagnosis remains highly challenging. Currently, imaging examinations are important tools for diagnosing PDAC. This case report is of a 61-year-old female who presented with intermittent right upper quadrant pain that had persisted for more than one month. Imaging revealed localized focal parenchymal atrophy and indentation of the pancreatic parenchyma in the proximal body of the pancreas, with heterogeneous delayed enhancement on contrast-enhanced images. Histopathological examination confirmed the diagnosis as moderately to poorly differentiated PDAC in the proximal body of the pancreas. In addition, a systematic review of the clinical manifestations, imaging features, differential diagnosis, and treatment methods of PDAC was performed, to enhance the understanding of this disease and to improve the diagnosis from imaging.