Primary pancreatic squamous cell carcinoma is rarely recognized in pancreatic malignancies. Prior reported incidence was 0.2% to 0.5% in all pancreatic malignancies. Here we describe a 65-year-old woman with epigastric pain radiating to back for one month. After extensive workup, a large pancreatic head mass with pathology proven squamous cell carcinoma was diagnosed. Survey of other common site of primary sqaumous cell carcinoma was all negative. We discuss the possible oncogenic pathogenesis, clinical manifestations, treatment and prognosis of this rare disease. Existing literatures were also reviewed in order for better understanding of this rare pancreatic malignancy.