Objective The aim of this study was to evaluate the safety, feasibility, and oncologic outcomes of 3-dimensional total laparoscopic pancreaticoduodenectomy (3D-TLPD). Methods Data of all patients who underwent 3D-TLPD (n = 202) or open pancreaticoduodenectomy (OPD) (n = 213) at a single institution between October 2014 and December 2016 were reviewed. We evaluated the safety, feasibility, and oncologic outcomes of 3D-TLPD compared with OPD. Results The mean operative times in the 3D-TLPD and OPD groups were comparable (P = 0.322). The estimated blood loss and perioperative transfusion rate were similar in both groups, as were the morbidity and mortality rates (P > 0.050). The mean number of analgesic administered and the mean length of hospital and intensive care unit stay were lower (P < 0.001) and shorter (P < 0.001, P = 0.009) in the 3D-TLPD group than in the OPD group, respectively. The surgical resection margins and the number of lymph nodes harvested did not differ between the 2 groups; however, a significant difference was observed in pathological results. Conclusions Three-dimensional TLPD had the typical advantages of minimally invasive abdominal procedures, such as shorter hospital stays. It is technically safe and feasible and has comparable operative times and similar oncologic outcomes to those of OPD.