Pancreatic cancer is an indolent malignancy that is diagnosed at a late stage and has poor outcomes. In New Zealand (NZ), the overall 1-year survival is 21.8% and 2-year survival is 9.7% (Te Aho O Te Kahu, 2023). This study aims to look at the survival of patients in Hawke’s Bay, New Zealand and compare them to the rest of the country. Secondary outcomes will look at some of the reasons why survival outcomes may differ. This retrospective study collected information on all patients diagnosed and treated with pancreatic adenocarcinoma in Hawke’s Bay Hospital over a 19-year period from 2005-2023. The 1- and 2-year survival outcomes were collected as primary outcomes. Secondary outcomes included stage at diagnosis, treatment undergone, ethnicity, histological diagnosis, and 5-year survival. A total of 228 patients were identified as being diagnosed with pancreatic adenocarcinoma in this 19-year study period. The 1-year survival is 14.5% and the 2-year survival is 4.4%. Staging data showed 93% of patients were stage 3 or 4 at diagnosis. 77.2% underwent no treatment, 16.7% palliative chemotherapy, 4.8% surgery (with or without chemotherapy), and 3.5% had surgery abandoned after finding more extensive disease than expected. Ethnicity data showed 72.4% were NZ European and 13.6% Māori. A histologically confirmed diagnosis was done in 54.4%. The 5-year survival was 0.88%. Pancreatic cancer outcomes are reported in 1- and 2-year survivals due to the aggressive nature of the disease and poor outcomes. The 1-year survival in Hawke’s Bay according to this study is 14.5% (vs 21.8% in New Zealand) and the 2-year survival is 4.4% (vs 9.7% in New Zealand). The lower survival in Hawke’s Bay warrants further investigation. Te Aho O Te Kahu Cancer Control Agency (2023) Pancreatic Cancer Quality Improvement Monitoring Report https://teaho.govt.nz/application/files/5317/4052/0733/FINAL_WEBSITE_VERSION_Pancreatic_Cancer_Quality_Improvement_Monitoring_Report_CE_Approved.pdf