Acute pancreatitis (AP) is a severe gastrointestinal disease that causes hospitalization. Initial management within the first 72 hours after diagnosis is crucial for improving outcomes. Key aspects include assessing disease severity, fluid resuscitation, pain control, nutritional support, and antibiotic use. Recent updates emphasize goal-directed hydration with lactated Ringer's solution over aggressive normal saline. Early enteral feeding is beneficial, while prophylactic antibiotics are limited, with procalcitonin-based algorithms helping distinguish inflammation from infection. Urgent endoscopic retrograde cholangiopancreatography (ERCP) is indicated in gallstone pancreatitis with cholangitis but not otherwise. Management of local complications, such as infected necrotizing pancreatitis, involves tailored interventions based on severity and anatomical factors. Convalescent care includes cholecystectomy in gallstone pancreatitis, lipid-lowering drugs for hypertriglyceridemia-induced AP, and alcohol cessation in alcoholic AP. Recent strategies focus on early and individualized treatment to improve prognosis and prevent recurrence.Acute pancreatitis (AP) is a severe gastrointestinal disease that causes hospitalization. Initial management within the first 72 hours after diagnosis is crucial for improving outcomes. Key aspects include assessing disease severity, fluid resuscitation, pain control, nutritional support, and antibiotic use. Recent updates emphasize goal-directed hydration with lactated Ringer's solution over aggressive normal saline. Early enteral feeding is beneficial, while prophylactic antibiotics are limited, with procalcitonin-based algorithms helping distinguish inflammation from infection. Urgent endoscopic retrograde cholangiopancreatography (ERCP) is indicated in gallstone pancreatitis with cholangitis but not otherwise. Management of local complications, such as infected necrotizing pancreatitis, involves tailored interventions based on severity and anatomical factors. Convalescent care includes cholecystectomy in gallstone pancreatitis, lipid-lowering drugs for hypertriglyceridemia-induced AP, and alcohol cessation in alcoholic AP. Recent strategies focus on early and individualized treatment to improve prognosis and prevent recurrence.