Complications from acute pancreatitis may rise at any point in the disease’s time course, and result in significant morbidity and mortality. Because acute pancreatitis is a local and systemic disease, complications from an acute episode span different organ systems. Notable complications include arterial pseudoaneurysm and hemorrhage, venous thrombosis, intra-abdominal hypertension, thoracic complications, and other gastrointestinal tract complications. These range in severity such as intra-abdominal hypertension and stable thromboses to life-threatening abdominal compartment syndromes and hemorrhages. Each requires early recognition and treatment by a multidisciplinary team.