Background: Acute pancreatitis is still a disease with a high mortality. Recently it was agreed in Atlanta on two classifications mild and severe form. Necrosectomy is the most efficient method of treatment. This was confirmed by our clinical material in years 1998–2006. Aim: The analysis of incidence of severe pancreatitis with necrosis over 30% in female and male patients. Methods of surgical treatment. Material and methods: In years 1998–2006 we treated 76 patients with acute pancreatitis. 64 patients were operated (84.2%), conservative treatment 15.8%. Female – 34.3% of patients, male 65.7%. 16 patients was maked necrosectomy. Results: Mortality of patients with severe acute pancreatitis is 8.3%. Total mortality 3.9%. Among patients after necrosectomy mortality was 0%. Conclusions: Alcohol-aetiology is associated with male sex. Necrosectomy is the best method of necrotizing acute pancreatitis.