Acute pancreatitis (AP) is a leading gastrointestinal disease that often requires hospitalization. Initial management within the first 72 hours is crucial for determining the clinical course and outcomes. Key aspects include assessing disease severity, fluid resuscitation, pain control, nutritional support, antibiotic use, and endoscopic retrograde cholangiopancreatography (ERCP) in gallstone pancreatitis. Recent updates have shifted from aggressive hydration with normal saline to goal-directed and non-aggressive hydration with lactated Ringer’s solution. Early enteral feeding is increasingly recommended, and prophylactic antibiotics are generally limited, with procalcitonin-based algorithms being investigated to distinguish between inflammation and infection. Urgent ERCP is indicated for gallstone pancreatitis and cholangitis but not for those without cholangitis. Local complications, particularly infected necrotizing pancreatitis, require detailed management, including indications, timing, anatomical considerations, and intervention methods. Convalescent treatments, such as cholecystectomy in gallstone pancreatitis, lipid-lowering medications in hypertriglyceridemia-induced AP, and alcohol intervention in alcoholic pancreatitis, are important for improving prognosis and preventing recurrence. This review focuses on recent updates in initial and convalescent management strategies for AP.Acute pancreatitis (AP) is a leading gastrointestinal disease that often requires hospitalization. Initial management within the first 72 hours is crucial for determining the clinical course and outcomes. Key aspects include assessing disease severity, fluid resuscitation, pain control, nutritional support, antibiotic use, and endoscopic retrograde cholangiopancreatography (ERCP) in gallstone pancreatitis. Recent updates have shifted from aggressive hydration with normal saline to goal-directed and non-aggressive hydration with lactated Ringer’s solution. Early enteral feeding is increasingly recommended, and prophylactic antibiotics are generally limited, with procalcitonin-based algorithms being investigated to distinguish between inflammation and infection. Urgent ERCP is indicated for gallstone pancreatitis and cholangitis but not for those without cholangitis. Local complications, particularly infected necrotizing pancreatitis, require detailed management, including indications, timing, anatomical considerations, and intervention methods. Convalescent treatments, such as cholecystectomy in gallstone pancreatitis, lipid-lowering medications in hypertriglyceridemia-induced AP, and alcohol intervention in alcoholic pancreatitis, are important for improving prognosis and preventing recurrence. This review focuses on recent updates in initial and convalescent management strategies for AP.