Malignant tumors in the pancreatic head region refer to the malignant cell proliferation originating from the head of the pancreas and its surrounding areas, with an increasing incidence year by year. The most common types are pancreatic ductal adenocarcinoma (PDAC), ampullary carcinoma, and distal bile duct carcinoma. The surgical treatment for malignant tumors in the pancreatic head region is pancreaticoduodenectomy (PD) and its modified procedures. Although surgical techniques have advanced, the long-term survival rate of patients remains low. The prognostic differences and advantages of different surgical approaches are still controversial, and they are affected by the experience of surgeons and the surgical volume of medical centers. The main factors affecting the prognosis of surgical treatment for malignant tumors in the pancreatic head region include the lesion site, tumor size, lymph node metastasis, vascular and nerve invasion, and the status of resection margins. Personalized surgical plans and adjuvant treatment strategies can be formulated based on these factors to improve the survival rate and quality of life of patients. This article reviews the current status of the prognosis of surgical treatment for malignant tumors in the pancreatic head region and related factors, aiming to provide a scientific basis for clinical practice.