Pancreatic cancer is one of the most lethal malignancies, largely due to the limitations of current imaging technologies and treatment strategies, which hinder early diagnosis and effective disease management. Achieving precise theranostics for pancreatic cancer has become a priority, and recent advances have focused on the development of novel nanomaterials with enhanced imaging capabilities and therapeutic functionalities. These nanomaterials, through surface modifications, can significantly improve the targeting and precision of both diagnostic and therapeutic applications. Recent progress in nanomaterial design has led to the creation of multifunctional platforms that not only enhance imaging but also improve therapeutic efficacy. These innovations have spurred significant interest in the application of nanomaterials for pancreatic cancer theranostics. In this review, we highlight recent developments in the use of nanomaterials for diagnostic imaging and precision therapy in pancreatic cancer. Various applications, including magnetic, optical, acoustic and radiological imaging, as well as therapeutic strategies such as chemodynamic therapy, light-based therapy, sonodynamic therapy and gene therapy, are discussed. Despite the promising potential of these nanomaterials, several challenges remain. These include optimizing targeting mechanisms, enhancing nanomaterial stability , overcoming biological barriers and ensuring safe and effective translation to clinical settings. Addressing these challenges will require further research and innovation. With sustained efforts, nanomaterial-assisted diagnostics and therapeutics have the potential to revolutionize the management of pancreatic cancer, ultimately improving early detection and treatment outcomes. Continued progress in this field could significantly enhance the overall prognosis for pancreatic cancer patients, making it a more treatable disease in the future.