Objective To intensify clinical evaluation on the manifestation, diagnosis and treatment of primary malignant duodenal tumors. Method The clinical data of 81 patients with primary malignant duodenal tumors from 1990 to 2002 were analyzed retrospectively. Result Tumors located above, around and below the duodenal papilla accounted for 16%, 78%, 6% respectively. The common clinical presentations were weight loss(72%)?abdominal pain(64%)?jaundice(45%)?alimentary tract bleeding(40%)?vomiting(33%) and anemia(24%). The preoperative diagnosis rate was 80%. Pancreatoduodenectomy was performed in 54 cases, bypass operation in 21 cases, segmental duodenectomy and simple laparotomy in 2 cases each. The postoperative 3- and 5- year survival rate was 36% and 21% for patients undergoing curative resection. In those with bypass operation, the survival time was between 1～18 months. Two cases undergoing segmental duodenectomy died within one year. Conclusion Patients usually lack special symptoms and signs, early diagnosis is fairly difficult, pancreaticoduodenectomy performed for purpose of curative resection could improve the prognosis of this malignancy.