Local pancreatic duct stricture (LPDS) is defined as focal narrowing, cutoff or irregular tapering of the main pancreatic duct or branch pancreatic ducts, which may be accompanied by upstream pancreatic duct dilatation, parenchymal atrophy, impaired pancreatic juice drainage, calculi, pancreatic fistula or recurrent pancreatitis. LPDS can result from benign conditions including chronic pancreatitis, pancreatic duct stones, postoperative anastomotic stricture, trauma and autoimmune pancreatitis; it may also serve as an early indicator of pancreatic ductal adenocarcinoma, high-grade pancreatic intraepithelial neoplasia (PanIN), intraductal papillary mucinous neoplasm (IPMN) or other neoplasms. In recent years, advances in endoscopic retrograde cholangiopancreatography (ERCP), endoscopic ultrasonography (EUS), peroral pancreatoscopy (POPS), EUS-guided pancreatic duct drainage (EUS-PD), sequential pancreatic juice cytology, EUS-guided fine-needle aspiration/biopsy (EUS-FNA/FNB) and pancreatic duct stenting have transformed the diagnosis of LPDS from simple morphological assessment to an integrated "imaging-endoscopy-histology-molecular" evaluation. Correspondingly, treatment has evolved from straightforward dilation and stent placement to individualized strategies stratified by etiology, anatomical features and risk profiles. This review summarizes the definition, etiologies, endoscopic diagnostic algorithms, management of benign and malignant strictures, interventions for refractory strictures, prevention and treatment of complications, and cutting-edge advances of LPDS, aiming to provide evidence for establishing standardized and practical endoscopic diagnosis and treatment workflows in clinical practice.