Currently, total pancreatectomy (TP) is indicated in approximately one in ten surgical patients with pancreatic cancer. Key role in the decision falls in the competence of the multidisciplinary team, alternatively of the surgeon in the intraoperative period in some cases. Exceptionally, TP is approached in the so-called salvage surgery. Perioperative mortality of TP as an elective procedure does not exceed that of partial resections; however, mortality of up to 50% is associated with salvage surgery in acute postoperative pancreatitis. Postoperatively, patients are afflicted with the so-called brittle diabetes comparable with type 1 diabetes. The aim of our overview is to inform about the current position of TP in the treatment of malignant pancreatic diseases.Key words: pancreatic cancer - total pancreatectomy - multidisciplinary team.