Nutritional support in the form of total parenteral nutrition (TPN) or enteral nutrition (EN) is successfully used in patients with pancreatitis, in whom the goal is to provide optimal nutrition while minimizing pancreatic exocrine activity. Controversy continues as to whether TPN or EN is more appropriate. Although TPN is traditionally preferred in acute pancreatitis, EN offers some advantages, being more physiologic, safer, and more cost-effective. A review of available animal and human studies suggests that elemental diets may be effective in patients with mild acute pancreatitis. In patients who have no clinical indication for restricting the gastrointestinal tract, EN may be preferred.