Postoperative complications after pancreaticoduodenectomy (PD) occur at a high rate of up to 40%, thus early prediction and management of its complications are necessary. Postoperative hyperamylasemia (POH) following PD is considered a predictor of the occurrence rate and severity of early postoperative complications, but due to the unclear mechanism of elevated serum amylase activity, its significance and implications have been interpreted in various ways in recent years. Here, the authors review the concept and development history of POH, its causes and impacts, its relationship with postpancreatectomy acute pancreatitis and postoperative pancreatic fistula, as well as prevention and treatment measures.