Pancreatic maldigestion is due to decreased intraluminal hydrolysis of foodstuffs which is the consequence of lowered concentration of pancreatic enzymes. This if caused by insufficient secretion, absent activation or increased inactivation so pancreatic enzymes in the intestinal lumen. In most cases maldigestion is a late syndrome in diseases of the pancreas because of its extensive functional reserve. The diagnosis of pancreatic maldigestion is relatively simple. The replacement therapy with pancreatic enzymes gives satisfactory results in most subjects. The substitution of other substances (vitamins, calcium) is carried out according to similar lines as in malabsorption of other etiology. In addition to foodstuffs digestion some other assimilation functions of the pancreas have been recognized recently. These may be of considerable importance for the integrated course of the digestive-absorptive processes.