INTRODUCTION: Malnutrition has been determined to be an independent risk factor for morbidity and mortality in patients undergoing surgical procedures. A prospective study was undertaken to estimate the prevalence of malnutrition in patients and to evaluate the effect of preoperative malnutrition on the early postoperative outcome in patients undergoing pancreaticoduodenectomy. METHODS: 49 patients underwent pancreaticoduodenectomy were included in the study. Preoperative nutritional status was evaluated by serum albumin, BMI, Malnutrition Universal Screening Tool (MUST), Triceps skinfold thickness (TSFT), Subjective Global Assessment (SGA). Effect of malnutrition on morbidity, mortality and length of hospital stay was assessed. RESULTS: Prevalence of malnutrition was high (BMI: 42.85%, TSFT: 61.22%, Serum albumin: 48.98%, MUST: 78.54%, SGA: 51%). The overall incidence of postoperative pancreatic fistula (POPF) and delayed gastric emptying (DGE) were 59.2% and 55.1% respectively. Patients categorized as malnourished by SGA had significantly higher risk of POPF (80% vs. 33%; p = 0.001) and mortality (5% vs. 0%; p < 0.001). Serum albumin, MUST and TSFT were not predictive of early post operative outcomes. CONCLUSION: The prevalence of malnutrition in patients undergoing pancreaticoduodenectomy is high. SGA is a reliable parameter in predicting postoperative morbidity and mortality