Pancreatic cancer (PC), a lethal condition with poor prognosis and aggressive behavior, ranks fourth among the most common causes of cancer-related mortality as early diagnosis of PC is so difficult, consequently, most cases at the time of initial diagnosis already harbor metastasis. The early detection and survival of PC cases depend mainly on the improvement of diagnostic approaches. This review spots light on the role of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) as a minimally invasive method in the early diagnosis of PC and differentiation between different pancreatic lesions. The discovery of new diagnostic and prognostic markers for PC will raise the accuracy of proper diagnosis and in turn, patients will gain better survival and prognosis. Insulin-like growth factor II mRNA binding protein3 (IMP3) is overexpressed in several malignant tumors, including pancreatic cancer, which may raise its role in diagnosis and prognosis as well as its therapeutic benefit for PC.