The aim of the study was to compare endosonographic signs of pancreatic lesion in patients with inflammatory bowel diseases (IBD) and in patients with diagnosed chronic pancreatitis (CP). Materials and methods. 62 patients with IBD (39 with ulcerative colitis (UC), 23 with Crohn’s disease (CD)), 33 patients with previously established CP without IBD and 42 patients without CP and IBD were examined. All patients underwent endosonographic examination of the pancreas with an assessment of parenchymal and ductal criteria according to the Rosemont classification. Results. There was no statistically significant difference when comparing changes in the pancreas in UC and BC. Ductal disorders in patients with UC and CD were more common than in the control group. Parenchymal changes of the pancreas were statistically significantly more common in patients with IBD than in CP, and ductal, on the contrary, less common. At the same time, a significant difference was determined between the frequency of ductal changes in IBD and CP when compared with the control group. According to the Rosemont classification, certain CP was more common in patients with previously verified gland damage, probable - in patients with IBD. Conclusion. Based on the results of our study, with different etiologies of CP, endosonographic changes in the pancreas will manifest in different ways. A detailed approach to the etiology of CP will optimize the diagnosis and treatment of pancreatic insufficiency, and as a consequence of the underlying pathology of the intestine. Timely administration of therapy for changes in the pancreas can help to avoid progressive changes in the pancreas and improve the prognosis of the disease.