Abstract: Objective: To investigate the surgical treatment strategies for raising cure rate and decreasing fatality of severe acute pancreatitis. Methods: The clinical data of non-operative treatment and operative treatment for 52 patients with severe acute pancreatitis were retrospectively analyzed. Results: For the non-operative treatment (n=37), the cure rate was 89.2% and fatality 8.1%, while for the operative treatment (n=15), the cure rate was 86.7% and fatality 13.3% (P>0.05). In the severe gradeⅠoperation rate was 24.1%, cure rate 93.1% and fatality 3.4%. In the severe gradeⅡoperation rate was 34.8%, the cure rate 82.6% and fatality 17.4% (P>0.05). The total operation rate was 28.8%, total cure rate 88.5% and total fatality 9.6%. Conclusions: The indication and timing for operation should be strictly managed. The surgical treatment strategies should be that non-operative comprehensive treatment is dominant and operative treatment is subordinate, which can raise the cure rate and decrease the fatality of severe acute pancreatitis.