Clinical trials play a critical role in addressing clinically significant questions, influencing guidelines, and identifying opportunities to improve the use of novel and existing therapeutics. The Japanese pioneers in pancreatic surgery have established several collaborative study groups, and have provided good quality of data from well-designed clinical trials so far. Project study groups from the Japanese society of hepatobiliary and pancreatic surgery and the Japan pancreas society, PREP, JASPAC, JCOG, and local study groups located at Hokkaido, Tohoku, Nagoya, Wakayama, Osaka, Hiroshima, Kyusyu etc. in Japan have been in active and in collaboration with other countries such as Korea, Taiwan, China, US, and European countries. Personally, I have conducted multicenter retrospective study, prospective cohort study, randomized controlled trial (RCT), and double-blind RCT with domestic and overseas institutions. However, majority of clinical trials is a retrospective study which means a lack of solid evidence. In the modern era when number of publications has increased, clinical practice guideline has been established, and surgical technique or peri-operative management has been standardized, RCT or prospective cohort study as a collaborative one is definitely required for making solid evidences which can greatly contribute to patients and their family, medical stuff, society, and country. Recently, medical technology has been advanced with high speed, and medical doctors have a responsibility to establish best standard practices for its use for our patients rapidly and appropriately. The Asian patients with pancreatic disease are different from the Western patients in terms of physique, response to drugs, surgical techniques, post-operative morbidity and mortality and so on. The Asian surgeons need to make solid evidences for the Asian patients. Therefore, it is essential to build the larger study group in the Asia which can obtain funding from a variety of sources, including institutional support, public funding, or philanthropic gifts (crowdfunding etc.). The time has come for establishing the Asian pancreas study group.