Objective To explore the application effect of early progressive resistance training in postoperative rehabilitation of patients with pancreatic cancer complicated with sarcopenia, and evaluate its safety. Methods A total of 96 patients with pancreatic cancer and sarcopenia admitted to the Department of Hepatobiliary and Pancreatic Surgery were enrolled and divided into two groups according to their hospitalization periods. The control group received routine postoperative mobilization, whereas the intervention group was subjected to the early progressive resistance training. Outcomes including muscle strength, grip strength, the Brief Fatigue Inventory (BFI) scores, postoperative rehabilitation parameters and complication rates were compared between the two groups.Safety of early progressive resistance training was also assessed. Results Forty-seven patients in the control group and 49 patients in the intervention group completed the intervention. After the intervention, the intervention group showed significantly better muscle strength and grip strength than the control group; the between-group effect, time effect and interaction effect of fatigue scores at different hospitalization time points were statistically significant (all P<0.05). The time to first postoperative flatus, defecation and liquid diet intake in the observation group were significantly earlier than those in the control group, and the incidence of pulmonary infection was lower (all P<0.05). No severe adverse events such as muscle strain, falls and catheter dislodgement occurred in either group.Conclusion Early progressive resistance training for patients with pancreatic cancer and sarcopenia can effectively improve their muscle strength and grip strength, relieve cancer-related fatigue, accelerate the recovery of gastrointestinal function, reduce the risk of pulmonary infection, and facilitate postoperative rehabilitation.