Interventional radiologic catheter drainage may be an effective therapeutic approach to fluid collections complicating acute pancreatitis. Pancreatic pseudocysts and abscess are the most common conditions requiring radiologic intervention. Imaging guidance is best performed under CT control allowing precise definition of access route, catheter placement, and response. Access routes are chosen to avoid traversing vital intervening structures, especially the pleural space, colon, and small bowel. Optimal results are achieved with the use of large-bore multihole catheters, prolonged duration of drainage, and careful collaboration with the surgical team.