Acute pancreatitis is an inflammatory disorder, that is classically accompanied by abdominal pain and elevated serum lipase and amylase levels. While about 80% of the patients recover without complications, 20% develop severe local and systemic damages. Gallstone migration into the common bile duct and excessive alcohol abuse account for most of the cases, but also drugs have been shown to induce acute pancreatitis. Treatment of acute pancreatitis is only supportive, especially in severe episodes an interdisciplinary cooperation of gastroenterologists, radiologists, intensivists, and surgeons is required. The better understanding of the pathophysiology might merge into more tailored therapeutic procedures and improve the outcome of this disease.