Abstract: To evaluate by meta-analysis the long-term efficacy of adjuvant chemotherapy and surgery-only for resectable pancreatic cancer. Methods: Related articles ( from 1969 to 2011 ) were searched in MEDLINE, EMBASE, CMB, and ASCO. The qualities of the included studies were evaluated by the Jadad scale. Randomized clinical trials for adjuvant chemotherapy ( i.e., cisplatin and 5-fluorouracil, 5-fluorouracil and folinic acid, and gemcitabine ) and surgery-only in early pancreatic cancer were selected. One-, three-, and five-year overall survival ( OS ) and disease-free survival ( DFS ) rates were evaluated by meta-analysis. Results: A total of 6 studies were adopted, and the total number of cases was 1019. There were 515 cases in the adjuvant chemotherapy group and 504 cases in the surgery-only group. Comparing adjuvant chemotherapy with surgery-only, a 4% relative increase was obtained in the 1-year OS rate ( P = 0.4 ), and the relative increase was 8% in the 3-year OS rate ( P = 0.001 ). The relative increase in the 5-year OS rate was 6% ( P = 0.0009 ). However, there were no significant differences between the 1 and 5-year OS rate . In terms of DFS, a 23% relative increase was obtained in the 1-year DFS rate ( P < 0.00001 ), and the relative increase was 8% in the 3-year DFS rate ( P = 0.006 ). The relative increase in the 5-year DFS rate was only 3% ( P = 0.11 ). No significant difference between the 5-year DFS of the two groups was found. Conclusion: Adjuvant chemotherapy can improve 3- and 5-year OS rates and 1- and 3-year DFS rates. However, no significant improvement in the 1-year OS rate and the 5-year DFS rate in resectable pancreatic cancer was observed.