The pathophysiology of acute pancreatitis remains controversial. Activation of digestive enzymes in the pancreas may play an important role in the course of this disease. Therefore, the inhibition of enzyme secretion may be a possible treatment concept. However, it is not clear whether pancreatic secretion continues during the course of acute pancreatitis. In the present paper experimental and clinical studies are reviewed to evaluate the effect of somatostatin and octreotide treatment in acute pancreatitis.