The review article examined the problem of assessing the state of the pancreas in obesity in adults and children, reveals the definitions that are used in medicine for changes in the pancreas, indicates the inconsistency of terms related to the deposition of fat cells in the pancreas. Diagnostic possibilities of anamnesis, objective status, paraclinical data (laboratory, instrumental indicators) are shown, the close connection of pancreatic fat infiltration with non-alcoholic fatty liver disease and metabolic syndrome is emphasized. It is emphasized that the determining value in determining the fat infiltration of the pancreas is given to ultrasound examination, which is assigned the role of screening, computed tomography and magnetic resonance imaging, with their high sensitivity and specificity. It is indicated that the literature data on the assessment of the state of the pancreas in children with obesity are few and ambiguous.