Objective：To analyze retrospectively the one-year survives of patients with inoperable pancreatic cancer treated by high intensity focused ultrasound by a multiple-center clinical trial. Methods：From January 2013 to January 2014，32 patients with in-operable pancreatic cancer from China and Bulgaria were involved into the trial. They are male/female=20/12，aged 59.8±9.1（41-81） years. The size of tumor is 39.3±9.6（20-60） mm. the number of patient with/without metastasis are 18/14.The treatment protocol is HIFU or HIFU plus Chemotherapy. The complications，pain levels and survives were recorded after HIFU. The overall survival rate（OS） and median survival time（MST） were calculated by Kaplan-Meier method，and the differences between patients with/without adjuvant chemotherapy or metastasis were compared with log-rank method. Results：Two patients with degree Ⅱ° skin burn were recorded in one month post-HIFU and were cured in 1-2 weeks with conservative treatment. Comparison was made on 30 patients with pancreatic cancer related pain pre-HIFU and post-HIFU. Post-HIFU，the pain levels got released in 24 cases（80.0%），no changed in 5 cases（16.7%），worse in 1 case（3.3%）. The OS of all cases in one year was 38.4% and MST was 12 months. The OS of patients accepted HIFU plus adjuvant chemotherapy/HIFU in one year was 57.4% and 20.8% and MST was 12 months and 6 months，respectively with significant dif－ferences. The OS of patients with/without metastasis was 0% and 49.2% and MST was 7 months and 12 months，respectively without significant differences. Conclusion：All patients from China and Bulgaria with inoperable pancreatic cancer completed the HIFU safely. The one year OS and MST are better than other non-operative methods. HIFU plus adjuvant chemotherapy benefits to the survival，while metastasis is a poor prognosis factor.