Intraoperative electron beam radiation therapy (IOERT) is a technique in which a single high fraction radiation treatment is administered at the time of surgery. Using IOERT, the total radiation dose delivered to a tumor can be increased since sensitive normal tissues are removed from the radiation field during the surgical procedure. Furthermore, while the biologic effectiveness of this single fraction is incompletely understood, it is believed to be equivalent to that of a dose at least two times greater given by means of conventional fractionation. IOERT may improve local tumor control in patients with resectable or locally advanced pancreatic cancer. At the Massachusetts General Hospital (MGH), IOERT is being investigated in the management of pancreatic cancer as a boost treatment in combination with external beam radiation, surgery and chemotherapy.