Abstract: Pancreatic cancer with liver metastases (PCLM) is a refractory malignant tumor characterized by insidious onset, rapid progress, and poor prognosis. Only a few patients had the opportunity of receiving surgical treatment. PCLM is primarily treated by systemic chemotherapy. The chemotherapeutic regimen of 5-fluorouracil, oxaliplatin, irinotecan, and leucovorin has become the first-line therapy for PCLM patients with good performance status. Gemcitabine-based chemotherapy is still very important in treating PCLM. Nab-paclitaxel plus gemcitabine, which has been found to increase survival, is recommended as a new standard for treating PCLM patients. However, still no breakthrough has been established in the study of gemcitabine plus molecular-targeted therapy. Systemic chemotherapy combined with trans-catheter arterial chemoembolization is valuable and may be effectual in prolonging survival. Further investigation of prospective and randomized controlled clinical trials is necessary. Radio frequency ablation and brachy-therapeutic embolization with yttrium-90 microspheres are still in the exploratory stage. Multimodality treatment of PCLM using chemotherapy, radiation therapy, and Chinese herbal medicine is gaining wide acceptance. This article reviews the recent progress in the treatment of PCLM.