Abstract： Objective To study the effect of endoscopic treatment in acute severe pancreafitis. Methods EST(endoscopic sphincterepapiilotomy) and ENBD ( endoscopic naso-billary dralnage) or ENPD ( endoscopic naso-pancreatic drainage) were used to treat the acute severe pancreatitis(ASP). Results The recover time of blood dia-stase of the endoscopic therapy group and the contrast group was (3.2±1.5) days, (6.6±1.2) days, respectively (P<0.01) ; the incidence of needing to be operated was 0.7% (1/140), 6.5% (8/124), respectively (P<0.05) ;mortality rate was 0:7% (1/140) ,7. 3% (9/124) ,respectively(P <0. 01 ) ;the incidence of complication was 3.6% (5/140) ,41.9% (52/124), respecfivly(P<0.01). Conclusion EST + ENBD(or ENPD) in treating ASP has cer-tain effect and is the primary therapy to the ASP.