An increased incidence of acute pancreatitis from a variety of causes is being seen in the pediatric population. The pathophysiology of pancreatitis autodigestion is poorly understood. The diagnosis is sometimes difficult to establish if the child is not seen during an acute episode when serum amylase and lipase levels may be elevated. Family history is important in the diagnosis of idiopathic hereditary pancreatitis. Laboratory and radiological studies play an important role in determining the diagnosis and prognosis of pancreatitis. Most acute episodes resolve with supportive care, but the mortality in acute pancreatitis is currently about 15%. Endoscopic retrograde cholangiopancreatography may be necessary to investigate relapses of pancreatitis. Chronic pancreatitis can be a life-threatening condition requiring lifetime medical management.