During this presentation, the current evidence regarding the difficulties encountered when diagnosing pancreatitis will be reviewed. Achieving a definitive diagnosis may be difficult and the lack of an ideal gold standard limits our assessment of the condition. Clinicopathological abnormalities, imaging modalities and histopathology will be compared for both acute and chronic pancreatitis, with a focus on the risk of false positive and false negative results. Whilst the management of acute pancreatitis has been well described, certain therapeutic options have been challenged, such as antibiotherapy or low fat diet. Management of chronic pancreatitis is less well documented and focus essentially on management of diabetes mellitus and exocrine pancreatic insufficiency and supportive treatment during acute-on-chronic episodes of pancreatitis.