Abstract: Nowadays, some new characteristics emerge in the modern management of severe acute pancreatitis (SAP), such as minimally invasive, staging, multidisciplinary, specialized and diversified. There is a prevalent insufficiency in the surgical management of SAP due to various reasons. A precise grasp of timing, indication and manner in the surgical management of SAP is of great importance to further improve the curative rate. Surgical intervention of SAP is performed in a staged step up framework, which should not only be indicated by infectious complications in the late phase of SAP, but also by a failure of nonsurgical therapy and a progression to abdominal compartment syndrome and/or multiple organ failure (MOF) in the early phase of SAP. In a staged stepup framework, imaging guided percutaneous catheter drainage could be established relatively early, MOF and heterogeneous collection are independent risk factors of the necessity of surgical debridement, and the merits of open debridement should not be under estimated. A same-admission cholecystectomy could be arranged for patients with gallstone SAP, and laparoscopic cholecystectomy serves as the initial choice. In the context of minimal invasiveness and diversification, the surgeons should endeavor to establish their predo minant role in the multidisciplinary team, preventing from insufficient surgical intervention in the management of SAP.