Pancreatoduodenectomy (PD) is the standard procedure for the treatment of pancreatic head or periampullary malignancies, and some benign diseases as well as precancerous lesions. Pancreaticojejunostomy-associated postoperative pancreatic fistula (POPF) is one of the important causes for the adverse outcomes of the operation, bringing huge pain and economic loss to the patients and their families. Existing studies suggest that POPF may be the result of multiple factors, and pancreaticojejunostomy is one of the independent risk factors and also one of the important factors that can be controlled by surgeons. However, although there have been more than 100 reported pancreaticoenterostomy methods, POPF cannot be avoided and none of them have been fully recognized. So, pancreatic surgeons are keeping looking for a more reliable anastomosis between the pancreas and intestine. Nowadays, scholars at home and abroad have never stopped exploring pancreaticojejunostomy, and they are also making unremitting efforts in developing other measures to prevent pancreatic fistula. Based on the above background, the authors reviews the current situation of pancreaticojejunostomy and POPF prevention strategies, so as to help reduce the harm of POPF.