In the management of severe chronic pancreatitis, a variety of new endoscopic methods have been proposed as an alternative to traditional surgery. The main goal of these procedures is the remission of pain. They include pancreatic endoscopic sphincterotomy with subsequent endoscopic extraction, which can be associated to extracorporeal shock-wave lithotripsy for stone desintegration before removal of large calculi, and to the insertion of a pancreatic stent in case of a pancreatic duct stricture. We present two cases of severe chronic pancreatitis managed successfully with this endoscopic treatment.