Pancreatic exocrine insufficiency is discussed from the viewpoints of physiology, etiology, signs and symptoms, laboratory findings, and treatment. Characteristic manifestations are those of malabsorption, with steatorrhea. The pancreatic secretin test is still the most valuable laboratory tool, though quantitative determination of fecal chymotrypsin may ultimately prove to be more advantageous. Pancrelipase or various other combinations of digestive enzymes often provide effective therapy.