Background and Objective: Pancreatic cancer (PC) still represents one of the gastrointestinal cancers with the highest burden both in terms of incidence, prevalence and mortality rate. However, despite efforts in deeply understanding the aetiology of PC, it still remains unclear, with several identified potential risk factors, among them diet. However, little is known about the association between Mediterranean Diet (MedDiet) and risk of PC. Methods: A systematic review with meta-analysis has been carried out according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 (PRISMA) guidelines, searching on three scientific databases (PubMed/MEDLINE, Scopus, and EMBASE). The protocol was registered in PROSPERO (ID number: CRD42022367497). Newcastle-Ottawa Scale was used to assess methodological quality. Both fixed and random effect models were performed. The effect size was reported as hazard ratio (HR) with a 95% Confidence Interval (CI). I2 test was performed to measure the heterogeneity. Funnel plot and the Egger’s regression asymmetry test (p < 0.10) were used to asses publication bias. Prometa3® software was used to perform the statistical analyses. Results: A total of 8 articles were included. The methodological quality of the included meta-analyses was high. Our results show that higher adherence to MedDiet is associated with a lower risk of PC [HR:0.82 (0.76-0.88) p<0.001, based on 1,301,320 subjects]. Results were also confirmed in sensitivity and subgroups analyses (avoidance of potential overlapping effects, type of tools to assess dietary intake and the diagnosis of PC, prevalent and incident PC risk, country where the studies took place, sex and cancer site). Conclusions: Based on our results, and according to the NOURISHING framework developed by the World Cancer Research Found, investing public money in educating about healthy food choices might maximize healthier food choices. In this case higher adherence to MedDiet reduces risk of PC.