Objective To evaluate the clinical effect and safety of high intensity focused ultrasound (HIFU) for the treatment of advanced pancreatic carcinoma. Methods 21 cases of advanced pancreatic carcinoma were treated by FEP BY01 pyrotherapier (HIFU). Results After HIFU, abdominal pain was relieved in 88% of patients (15/17), ultrasonic echo of carcinoma tissue was enhanced in all patients, the bloodstream decreased significantly or disappeared, the tumor size and CT value had no significant change, PET examination showed that carcinoma was inactivated effectively, although the tumor size as evaluated by CT scan did not experience a shrinkage. There were no complications such as skin burns、pancreatic fistula、bleeding、 pancreatitis and perforation during the process. The mean survival time of the patients after HIFU was 7 6 months. Conclusion HIFU as a new local treatment effects a satisfactory palliation for patients with advanced pancreatic carcinoma.