Abstract Background: Pancreatic cancer is the 4th cause of cancer-related. Complete resection is the curative option but pancreatic surgery is a complex surgery. Pancreaticoduodenectomy is the treatment of choice for pancreatic tumors but delayed gastric emptying is a common after pylorus preserving pancreatico-duodenectomy and may lead to patient discomfort, prolonged hospitalization, and increased hospital costs. Aim of Study: This study aims to assess the incidence and management of delayed gastric emptying in management of periampullary cancer. Patients and Methods: This was a prospective cross-sectional study conducted on 20 patients with pancreatic head or periampullary carcinoma managed via ppPD whom suffered from delayed gastric emptying during the period from 1st of November 2020 to the 31st of October 2021 at department of Hepato-Pancreato-Biliary Surgery, National Liver Institute, Menoufyia University. All patients were evaluated preoperatively and followed-up postoperatively when DGE developed for its signs, diagnosis and possible managements. Data were fed to the computer using IBM SPSS software package version 20.0. Results: Our results revealed a non-significant demograph-ic data, comordinities, viral infection, laboratory investigations "pre or post-operative", operative findings and postoperative outcomes and hospital stay. But predominance of male gender, pathologic grade II, and the significance of radiologic inves-tigations in diagnosis (U/S, CT, MRCP), response of DGE to conservative management. Conclusion: Diagnosis of DGE should be early post-operative which is commonly presented by GIT symptoms and successfully treated conservatively.