Abstract: Objective: To evaluate the effectiveness and toxicity of high intensity focused ultrasound (HIFU)combined with gemcitabine in treatment for older pancreatic cancer.Methods: Twenty-six older pancreatic cancer late cases from our hospital were divided into two groups,all patients were given HIFU treatment,the observation group were added gemcitabine single-agent chemotherapy, the control group did not received chemotherapy.Clinical benefit response,clinical curative effect, the concentration of CA199 and side-effect were observed after 2 treatment course.Results: The effective rates of the observation group and control group were 69.23% and 23.08%, respectively and the concentration of CA199 of both the observation group and control group dropped to 84.62% and 38.46%, respectively.The differences had statistical significance (P = 0.047 and P = 0.041).The clinical benefit responses of the observation group and control group were 69.23% and 38.46%,respectively, the difference had not statistical significance(P = 0.238),and their side-effects were not serious.Conclusions: HIFU combined with chemotherapy can control tumor growth, improve the quality of life, reduce the CA199 concentration and cause light side-effect for patients.