Pancreatic cancer is a highly malignant tumor with dismal prognosis and poor responses to classical chemotherapeutic agents and targeted drugs. Thereinto, tumor microenvironment of pancreatic cancer plays an important role in the development of drug resistance. Nanomedicines are promising candidates for the treatment of pancreatic cancer, because of the advantages of appropriate size and high stability in circulation as well as the enhanced permeability and retention effect, in combination with the strategies such as photosensitive and pH-response controlled drug release, they can effectively penetrate through the tumor microenvironment and target at the cancer cells. Here, the authors review the strategies for using nanomedicines in the treatment of pancreatic cancer, including ferroptosis-inducing nanomedicines, conventional chemotherapeutic agent- or siRNA-loaded nanocarriers, photodynamic nanoagents and some other strategies, and also summarize the recent progress, relevant clinical trials and current problems.