Ten patients with necrotizing pancreatitis admitted consecutively between August 1990 and August 1991 were studied. They comprised eight men and two women of median age 63 (range 29-73) years. One patient died. The median length of hospital stay was 74 (range 40-150) days. The median number of operations and endoscopic procedures performed per patient was 4 (range 2-7). Investigations performed included multiple bacteriological, radiological, haematological and biochemical tests. The mean cost of management was 18,441 pounds (range 9,296 pounds-33,796 pounds), of which hospitalization accounted for 65 per cent, operations and endoscopic procedures 20 per cent and investigations 16 per cent. Cost-utility analysis demonstrated a mean benefit per patient of 8.55 quality-adjusted life years gained at a cost of 2,157 pounds each. The management of pancreatic necrosis is expensive but justified by the excellent outcome in terms of quality of life.