Autoimmune pancreatitis is a rare disease which closely mimics pancreatic cancer in its presentation. It is important for clinicians to distinguish one from the other due to vastly different therapeutic and prognostic implications. We compared 2 recently proposed strategies, 1 from Japan and the other from the United States, to distinguish autoimmune pancreatitis from pancreatic cancer. While both strategies have inherent strengths and weaknesses, we believe that the best features of both need prospective validation. The strategy proposed from Japan is simple to use, but is based on a small number of patients and is heavily dependent on imaging criteria. The American strategy while based on a bigger sample of patients is complicated and is most useful in expert hands. Additionally, differences in clinical practice and local preference in the use of certain diagnostic tests need to be considered while adopting either strategy.