A deficiency of vitamin B12 may result from several causes. These include the absence of gastric intrinsic factor, impaired absorption of vitamin B12 due to abnormal bacterial overgrowth of the small bowel, and impaired transport of vitamin B12 due to a diseased terminal ileum. It is not generally appreciated that impaired vitamin B12 absorption may also be associated with pancreatic insufficiency.1-5 The present report describes studies in a patient with pancreatic insufficiency and vitamin B12 malabsorption in whom impaired absorption of vitamin B12 was corrected by treatment with pancreatic enzymes.