The management of patients with pancreatic cancer begins with confirmation of the diagnosis by cytology, which is followed by accurate preoperative staging and biliary drainage. Endoscopic ultrasonography with fine-needle aspiration (EUS-FNA) followed by endoscopic retrograde cholangiopancreatography (ERCP) helps to achieve these goals and primes the patient for various treatment options. We discuss the findings of a study by Ross and colleagues that aimed to determine the feasibility and outcomes of combining EUS-FNA and therapeutic ERCP in a single session. The authors concluded that combined EUS-FNA and ERCP was technically feasible, and could safely and effectively achieve a diagnosis and biliary drainage. The adverse event rate was acceptable; pancreatitis was the most common complication. Such a one-step approach is, therefore, beneficial and calls for the founding of well-equipped units with adequately skilled endoscopy and support staff.