Abstract: Severe acute pancreatitis (SAP) is recognized as c ritical refractory disease. The case fatality rate of SAP is as high as 36%-50%. Although signif icant progress has been achieved on the treatment of severe acute pancreatitis ( SAP) by Integrated Traditional Chinese Medicine (TCM) and Western Medicine (WM), there still exist some difficulties hindering the further improvement of therap eutic efficacy. The hot issues includes: unconfirmative curative effects and div erse treatment principles, complicated predictive scoring systems and inaccurate markers for the severity stratification, unproved new therapeutic tools and con troversial methods waiting more high qualified evidence, unclarified mechanism o f Integrated TCM and WM. In order to overcome the difficulties, we aim to launch the clinical pathway of Integrated TCM and WM, to strengthen the unity of multi disciplinary cooperation. We also need to keep the efforts on screening the mark ers for early evaluation and prediction of disease severity, improving the diagn osis and treatment, exploring the mechanism of Traditional Chinese Medicine in t reating SAP with more high quality basic and clinical research. Based on these e fforts, we could provide better treatments and prognosis for SAP patients.