A case is presented of an elderly female who was found by imaging to have an enlarged pancreas with narrowed distal common bile duct, thought to be neoplastic. Resection revealed an inflammatory and fibrosing process of the pancreas, suggestive of autoimmune disease. Subsequently she developed dry mouth, enlarged salivary glands, and an enlarged lacrimal gland with typical histology of Sjögren's syndrome. Pathological review of the contralateral lacrimal gland excised 20 years earlier showed similar histology. This case is a rare, but not unique, example of pancreatic pseudotumor associated with Sjögren's syndrome. The increasing use of sophisticated abdominal imaging may result in an increased detection of such pseudotumors. Failure to recognize their real nature can lead to inappropriate surgery.