Acute pancreatitis is being diagnosed more frequently in pediatrics and there is limited published research to guide management. In contrast, multiple prospective studies in the adult population have resulted in significant changes in the way the disease is managed, especially with regard to severe disease. The nutritional management of pediatric acute pancreatitis appears to lag behind current adult recommendations, likely resulting from a lack of awareness of the adult data, inherent differences between pediatric and adult pancreatitis, and the paucity of research performed in children. The purpose of this review is to examine the adult literature regarding the nutritional management of acute pancreatitis and discuss the possible relevance of this data in the pediatric population.