Objective: The meta-analysis was conducted to test the link between pancreatic cancer (PC) risk and dietary inflammatory index (DII®) score. Design: Systematic review and meta-analysis. Setting: We searched PubMed, Embase, Web of Science, and the Cochrane Library up to November 22, 2020, to identify the relevant studies. Studies that reported the risk estimates and the corresponding 95% confidence intervals (CIs) for the DII category and PC risk were included. The effect sizes were pooled using the random-effects model. Dose–response analysis was conducted where possible. Participants: Two prospective cohort studies of 634 705 participants (3 152 incident cases), and four case-control studies of 2 737 cases and 4 861 controls. Results: Overall, the pooled risk ratio (RR) indicated that individuals in the highest category compared with the lowest category had an increased PC risk (RR=1.45; 95% CI 1.11, 1.90; P=0.006). Meanwhile, significant heterogeneity was also revealed. The dose-response meta-analysis indicated that a 1-unit increase in the DII score was associated with the PC risk (RR=1.08; 95% CI 1.002, 1.166; P=0.045; I2=94.1%, P<0.001). Nonlinear result showed an increased risk of moving from fewer to more inflammatory borders with increasing DII score (P nonlinearity = 0.003; I2=76.5%, P<0.001). Subgroup analyses found that significant positive association between PC risk and DII score appeared to be in case-control studies (RR=1.70; 95% CI 1.16, 2.50; P=0.007) and studies with ≤31 DII components (RR=1.76; 95% CI 1.14, 2.72; P=0.011). Conclusion: These findings suggested dietary habits with high inflammatory features (high DII score) might increase PC risk. © 2021 Cambridge University Press. All rights reserved.