Over the last two decades, CT has come to play a dominant role in imaging the pancreas. Advancements in CT technology, including the development of spiral scanners and, more recently, multidetector row CT (MDCT) scanners, as well as the development of three-dimensional (3D) imaging software have significantly improved the ability of CT to image the pancreas and to evaluate a wide range of pancreatic pathology. In particular, CT is now considered to be the imaging modality of choice for the detection and pre-surgical staging of pancreatic cancer. This article reviews the current role of MDCT in the preoperative evaluation and staging of adenocarcinoma of the pancreas, including a discussion of dual-phase CT angiography and the role of 3D imaging.