Abstract： Objective To investigate the strategy to improve successful treatment for severe acute pancreatitis (SAP). Methods The study period was divided into from 1992 to 2000, and from 2001 to 2009.The patients during these two phases were comparable as regard to sex and age. Results The proportion of patients received anti-inflammatory medications from 2001 to 2009 was 88.7% (94/106), medications which can improve the pancreatic microcirculation were used in 93.4% (99/106), early enteral nutrition was used in 58.5% (62/106), medications which can protect intestinal barrier function were used in 98.1% ( 104/106),all these parameters were significantly higher than those (22.4%, 19/85; 43.5%, 37/85; 29.4%, 25/85;17.7%,15/85) from 1992 to 2000. Also from 1992 to 2000, more patients underwent operation such as basin-shaped open drainage, pancreatic necrosis debridement. While more patients underwent operation such as laparoscopic drainage, CT or B-ultrasound guided percutaneous drainage from 2001 to 2009. The proportion of patients underwent surgical treatment decreased from 56.5% (48/85) to 32. 1%(34/106); the survival rate increased from 68.8% to 84.0%. Conclusions The research progress of medications was the foundation to improve successful treatment for SAP. Operation was an important option during SAP therapy. The individualized treatment was beneficial to improve successful treatment for SAP.