BACKGROUND: Isolated pancreatic metastases from renal cell carcinoma may be treated by surgical resection in a curative intent. As they are frequently multiple, a good imaging workup is mandatory to plan the appropriate resection. The aim of this study was to define the imaging workup that should be performed in this setting. METHODS: We reviewed all patients who underwent pancreatic resection for metastasis of renal cell carcinoma in a single centre during a 20-year period. The results of the intraoperative ultrasonography were compared to those of the preoperative imaging and the final pathology results. RESULTS: Thirteen patients were studied. A CT scan was always performed whereas only three patients had a MRI (only one revealed another tumor). Intraoperative ultrasonography found new tumors in 50% of patients when it was performed (4/8) and modified the management in 40% of them, while preoperative PET scan was useless. CONCLUSIONS: Intraoperative ultrasonography is a low-cost and non-invasive technique that should be routinely included in the surgical exploration of pancreatic metastases from renal carcinoma.