The fatty pancreas is a newly recognized entity with limited available literature on its risk factors, pathogenesis, diagnosis, and management. Obesity and metabolic syndrome both are emerging pandemic in recent times and the fatty pancreas is closely linked with both of them. Though obesity is one of the most important risk factors for the development of a fatty pancreas, it is not perquisite for the development of same. Radiological investigations are the most commonly used modality for the diagnosis of the fatty pancreas; however, criteria to define fatty pancreas are still not present. Studies have shown that fatty pancreas is associated with metabolic syndrome, acute/chronic pancreatitis, pancreatic exocrine insufficiency, and the development of pancreatic carcinoma. However, none of the associations is proved to have a cause–effect relationship and it requires further exploration in future studies. Though the pathophysiological mechanism of the fatty pancreas is unclear, one can assume that similar to the nonalcoholic fatty liver disease the pathological changes of the fatty pancreas may be reversible. However, the effect of lifestyle modification, weight reduction, and medical therapy in reversing fatty pancreas and its sequelae still requires further exploration in future studies.