Acute pancreatitis is the most common gastrointestinal disease requiring in-hospital treatment. Mortality rate in severe acute pancreatitis is still high (about 15%). The main causes of mortality at the early stages are systemic inflammatory response and multiple organ failure. The main target damaged organs in patients with severe pancreatitis are lungs, kidneys and gastrointestinal tract. In later stages, the cause of mortality is sepsis following parapancreatic infection, intestinal barrier damage and translocation of pathogenic microbes and their toxins through the intestinal wall into the blood and lymph. Glutamine restores function of enterocytes and gastrointestinal tract, as well as reduces manifestations of systemic inflammatory response, incidence of infectious complications and risk of mortality in patients with severe acute pancreatitis.