Ductal adenocarcinoma is one of the most common and severely aggressive forms of pancreatic cancer. IGF-I is one of the factors that ensures survival and proliferation of tumor cells, and its increased concentration inside the tumor is a characteristic sign of many malignant formations. The goal of this minireview is to provide an up-to-date insight on the roles of the IGF-I/IGF-IR signaling pathway in carcinogenesis and potential opportunities for pharmacologic targeting of IGF-I/IGF-IR in pancreatic tumors.