Acute pancreatitis varies from mild to severe fulminant disease. Once the diagnosis of acute pancreatitis is established, the treatment is dependent on the early assessment of disease severity based on objective clinical and laboratory parameters. The purpose of this review is to describe the new developments in the treatment of acute pancreatitis which have an impact in the lowering of the morbidity and mortality. The roles of initial treatment and monitoring, nutritional support, specific therapy and antibiotic prophylaxis are analysed. The therapeutic approach to patients with early and late complications of acute pancreatitis could be medical, endoscopic or surgical and recommendations for relevant management are given.