Abstract: In severe acute pancreatitis (SAP), analgesic treatment not only relieves pain, but also affects outcomes of patient. Therefore, analgesic treatment has drawn increasing attention as part of the comprehensive treatment strategies in SAP. However, analgesic treatment of SAP is faced with many challenges, and consensus suggestions are nonexistent. Experts from the Chinese Abdominal Intensive Care Association of Asia Society of Emergency and Critical Care Medicine discuss and propose 21 critical issues of clinical concern regarding pain and analgesic treatment on disease and patient outcomes, choice of analgesics, and analgesic methods in SAP and formulated the Chinese expert consensus on analgesic treatment of severe acute pancreatitis (2022 edition) based on medical evidence and experts clinical experiences, with the aim of providing guidance for clinical practice and improving patient outcomes.