Background: Several markers have been proposed as diagnostic markers in patients with solid pancreatic lesions, including Carbohydrate antigen 19-9 (CA 19-9), Carcinoembryonic antigen (CEA) andVascular endothelial growth factor (VEGFA). The aim of the present study was to evaluate role of serum VEGF-A in predicting findings of Endoscopic ultrasound guided Fine Needle Aspiration (EUSFNA) of solid pancreatic lesions and if they are correlated to each other. Patients and methods: The study included forty six patients with solid pancreatic lesion who admitted to Internal Medicine department, endoscopy unit, Faculty of Medicine, Hospitals and Kasr EL-Ainy Hospitals, Cairo University. Patients were divided into 2 groups according to FNA findings, CT abdomen and /or MRI. All patients enrolled for full history and investigated with routine laboratory studies. EUS technique was performed. Results: In our study, the mean age of group I with malignant pancreatic lesions was 56 years while the mean age of group II with benign pancreatic lesions was 44 years percentage. There was significant difference between studied groups regarding age and smoking. No significant difference was found between studied groups as regards sex, diabetes mellitus and obesity. There were statistically significant differences between the malignant group of patients classified according to EUS stage (N) regarding CA19-9 and VEGF-A however no significant difference between them regarding CEA. VEGF-A at cut off value of˃ 1580 u/ml has a sensitivity of 66.6% and a specificity of 94.74%in detecting advanced malignant pancreatic lesions. Conclusion: different imaging modalities are used to assess pancreatic solid lesions, among them EUS is superior to CT and MRI owing to its high ability to detect, describe and stage pancreatic solid lesions. EUS-FNA could differentiate between various pathological pancreatic neoplasms.