Although obstructive jaundice in pancreatic inflammatory disease is being recognized with increased frequency, duodenal obstruction is thought to be unusual. The occurrence of both duodenal and biliary obstruction suggests pancreatic cancer, and has seldom been described in pancreatitis. We report three patients with combined duodenal and biliary obstruction occurring as a complication of chronic pancreatitis. Distinction from carcinoma by barium study or laboratory results alone was not possible; instead, it depended on studies of the common bile duct, exploratory laparotomy in two patients, and follow-up in all three.