Chronic pancreatitis is a progressive disease caused by repeated episodes of pancreatic inflammation and fibrosis, leading to loss of exocrine and endocrine pancreatic function. It presents with abdominal pain, reduced quality of life, malabsorption, diabetes, and increased risk of pancreatic cancer. This review summarizes the latest evidence on diagnosis and management, including advances in understanding genetic factors and surgical options for refractory cases. Clinical trials are ongoing to develop new therapies. Chronic pancreatitis is more common in men and is associated with alcohol misuse, smoking, genetic mutations, and ductal obstruction. Genetic factors such as PRSS1, SPINK1, and CTRC mutations contribute to disease progression. Pancreatic ductal abnormalities, such as pancreas divisum, can also play a role. Autoimmune pancreatitis is a distinct form of chronic pancreatitis that can present as painless jaundice. The fibro-inflammatory response in chronic pancreatitis involves pancreatic stellate cells (PSCs) and activated macrophages, leading to fibrosis and pain. TGF-β signaling is central to this process. Imaging, particularly CT and MRI, is crucial for diagnosis, with endoscopic ultrasound (EUS) used when needed. Biomarkers are being developed to improve diagnosis. Chronic pancreatitis can lead to exocrine and endocrine insufficiency, requiring pancreatic enzyme replacement therapy and management of diabetes. Pain management includes abstinence from alcohol and smoking, analgesics, and adjunctive medications. Endoscopic and surgical interventions are options for pain relief, with surgery showing better long-term outcomes than endoscopic techniques. Complications include pseudocysts, biliary strictures, and vascular issues. Pseudocysts are often managed with endoscopic drainage, while biliary strictures can be treated with stents. Vascular complications may require embolization or surgery. Differentiating chronic pancreatitis from cancer is challenging, but regular monitoring and imaging help. CA 19-9 levels can aid in suspicion of cancer. Patients with hereditary pancreatitis should be screened. Emerging treatments include inhibitors of TGF-β and interleukins, as well as vitamin D analogs. Clinical trials are exploring these therapies. Management guidelines emphasize stopping alcohol and smoking, treating exocrine and endocrine insufficiency, and considering endoscopic or surgical interventions. Published guidelines provide detailed recommendations for diagnosis and treatment.Chronic pancreatitis is a progressive disease caused by repeated episodes of pancreatic inflammation and fibrosis, leading to loss of exocrine and endocrine pancreatic function. It presents with abdominal pain, reduced quality of life, malabsorption, diabetes, and increased risk of pancreatic cancer. This review summarizes the latest evidence on diagnosis and management, including advances in understanding genetic factors and surgical options for refractory cases. Clinical trials are ongoing to develop new therapies. Chronic pancreatitis is more common in men and is associated with alcohol misuse, smoking, genetic mutations, and ductal obstruction. Genetic factors such as PRSS1, SPINK1, and CTRC mutations contribute to disease progression. Pancreatic ductal abnormalities, such as pancreas divisum, can also play a role. Autoimmune pancreatitis is a distinct form of chronic pancreatitis that can present as painless jaundice. The fibro-inflammatory response in chronic pancreatitis involves pancreatic stellate cells (PSCs) and activated macrophages, leading to fibrosis and pain. TGF-β signaling is central to this process. Imaging, particularly CT and MRI, is crucial for diagnosis, with endoscopic ultrasound (EUS) used when needed. Biomarkers are being developed to improve diagnosis. Chronic pancreatitis can lead to exocrine and endocrine insufficiency, requiring pancreatic enzyme replacement therapy and management of diabetes. Pain management includes abstinence from alcohol and smoking, analgesics, and adjunctive medications. Endoscopic and surgical interventions are options for pain relief, with surgery showing better long-term outcomes than endoscopic techniques. Complications include pseudocysts, biliary strictures, and vascular issues. Pseudocysts are often managed with endoscopic drainage, while biliary strictures can be treated with stents. Vascular complications may require embolization or surgery. Differentiating chronic pancreatitis from cancer is challenging, but regular monitoring and imaging help. CA 19-9 levels can aid in suspicion of cancer. Patients with hereditary pancreatitis should be screened. Emerging treatments include inhibitors of TGF-β and interleukins, as well as vitamin D analogs. Clinical trials are exploring these therapies. Management guidelines emphasize stopping alcohol and smoking, treating exocrine and endocrine insufficiency, and considering endoscopic or surgical interventions. Published guidelines provide detailed recommendations for diagnosis and treatment.