Background: A successful outcome to PD is attributed to a high volume at University Centers. Over the past decade, an association between volume and outcome in PD has been firmly established. Despite studies which suggest that community centers can perform these procedures with favorable outcomes, the underlying issue of where these complex surgeries should be performed is still debated. This paper examines the outcomes of PD in a NUTCC.Methods: Medical records of 122 patients, who underwent PD by a single surgeon between September 2005 to August 2008 at a high volume NUTCC, were analyzed. The patients were managed by a multidisciplinary team consisting of a gastroenterologist, surgeon, hepatobiliary fellow, general surgery residents, ICU nursing staff, operating room team, and a surgery floor nursing staff. The records were reviewed with respect to preoperative and postoperative data, thirty-day mortality, morbidity and histopathology data.Results:A total of 122 patients underwent PD. There was a female predominance with a male to female ratio of 0.84. Comorbidities were documented in 58 % patients. The mean age was 68 yrs. Jaundice was the most common presenting symptom in 68%. Preoperative ERCP with stenting was done in 41% patients. The mean operative time was 237 mins. The mean estimated blood loss was 480 ml. 32% underwent a pylorus preserving PD 35% patients received intraoperative blood transfusions, 20% received blood in the postoperative period. The mean length hospital stay was 13 days. Thirty day mortality was 3.2% and overall morbidity was 49 %. Reoperation was necessary in 5 % patients, mainly for wound problems.64% patients underwent PD for malignancy, of which 39% patients had carcinoma of the pancreatic head.44%patients underwent PD for benign disorders. The mean number of nodes retrieved was 15.Conclusions: PD can be performed at a NUTCC with results that meet and exceed nationally reported outcomes and benchmarks. The key elements to success in this endeavor include an incorporation of a multidisciplinary team for management of the PD patient.