This two-case report of medullary carcinoma of the pancreas adds to the limited experience published in the literature. Both patients initially presented with epigastric pain with an unremarkable physical exam. After an extensive diagnostic workup, they were both submitted to surgical resection. The histopathological report revealed a distinct entity with a medullary pattern, for which no current guidelines exist. However, this entity is known to have a better prognosis than pancreatic adenocarcinoma.