Abstract: Objective: To evaluate the effectiveness of our non-surgical strategy of severe acute pancreatitis. Methods: In a retrospective review,the efficacy of treatment was evaluated in patients with severe acute pancreatitis,by classifying the treatment into two stages according to the different principles of treatment. Results: The mortality rate descended from 25.0% in stage I(Jan,1995-May,1999) to 6.7% in stage II(Jun,1999-Mar,2001). Conclusion: Non-operative treatment is able to cure the majority of the patients with SAP as long as the effective steps are taken such as early volume resuscitation,intensive care unit,total parenteral nutrition,early prophylactic antibiotic treatment,sufficient somatostatin and acid inhibitors. ERCP and endoscopic sphincterotomy should be performed in severe gallstone pancreatitis.