Two children with Kawasaki disease presented with vomiting, back and abdominal pain, elevated serum amylase values, and ultrasonographic findings consistent with pancreatitis. In both patients, pancreatitis appeared after approximately two weeks of illness, and both patients underwent extensive evaluations, which yielded negative results, for other disorders associated with pancreatitis. We suggest that in the absence of acute infection, and in the presence of appropriate diagnostic criteria, pancreatitis should be considered in all patients with Kawasaki disease who have severe abdominal pain.