In the western world, acute pancreatitis is a frequent clinical entity. About 80% of patients with acute pancreatitis develop an edematous pancreatitis, whereas 20% develop a necrotizing pancreatitis: the later one, a potential life-threatening disease which needs intensive care. In this case an early enteral nutrition has been proven to improve the course of the disease. Usually, a gastric enteral nutrition with a polymeric formula via a nasogastric tube is possible; only in a minority a jejunal feeding is necessary due to a high gastric residual volume. In case of relevant intestinal maldigestion, an elemental formula is useful. If enteral feeding is not feasible within 5–7 days, (additional) parenteral nutrition has to be considered. The role of specific substrates is not clear.