Abstract: Acute pancreatitis (AP) is a disease of various causes,characterized by pancreatic enzyme activation and local pancreatic inflammatory response.Serious cases may develop systemic inflammatory response syndrome and even organ dysfunction.Severe AP (SAP) as a category of AP associated with persistent organ failure (>48 h) has an acute onset and high fatality rate.SAP accounts for about 5%-10%of all AP cases,with 30%-50% mortality rate.In this paper,we discuss the current status and main problems on the diagnosis and treatment of SAP based on the literature and our experience.