The availability of a presurgical pathological diagnosis in a patient with a pancreatic mass is considered mandatory by many researchers. Tissue diagnosis (primary tumor, nodes, or peritoneal fluid) combined with EUS staging (vascular invasion) determines whether the patient is a candidate for curative resection, neoadjuvant therapy, palliative surgery, or nonoperative therapy Ultrasound-Guided fine needle biopsy (UG-FNB) is a well established tool in the diagnosis of abdominal masses; it is rapid, inexpensive, safe, and highly accurate.Endoscopic ultrasound (EUS) accurately stages pancreatic masses It was reported that EUS is the best method for staging of pancreatic malignant masses.CA 19-9 is the most useful marker in patients with suspected pancreatic cancer. Its level correlates with the tumour burden and level of cancer expression and thus is often normal in patient with small tumours. It is estimated that only half of the patients with tumours 2 cm or less have elevated levels. In addition, normal values occur in some pancreatic tumours that donot produce CA 19-9. In addition, approximately 15% of individuals cannot synthesize this antigen.