Sjögren's syndrome (SS) is considered to be a universal exocrinopathy most likely based on autoimmune mechanisms. The degree of exocrine involvement in SS with the exception of salivary and lachrymal glands is, however, not yet established. We therefore examined the morphology, the exocrine and endocrine functions of the pancreas in 12 healthy consecutively included levolunteers with established SS, but without known pancreatic disease, using secretin-stimulated magnetic resonance cholangiopancreatography (MRCP), a Lundh test, oral glucose tolerance test, and blood sampling. Twenty-five percent of the patients had morphological changes of pancreas as evaluated by secretin-stimulated MRCP, and two patients had chronic pancreatitis-like changes. Four patients had reduced exocrine function of the pancreas with either significantly reduced amylase and/or lipase in the pancreatic juice. The prevalence of pancreatic dysfunction was increased to 25–33% in the study population which is much higher than in the background population. Thus, pancreatic dysfunction and chronic pancreatitis should be considered in SS.