The majority of acute pancreatitis cases resolve with nonoperative management. However, a small proportion develop pancreatic and peripancreatic fluid collections or necrosis. These are defined by the 2012 Revised Atlanta Classification of Acute Pancreatitis as four distinct categories as follows: acute peripancreatic fluid collection, pancreatic pseudocyst, acute necrotic collection, and walled-off pancreatic necrosis. These complications may require surgical intervention. Management of these complications requires a multidisciplinary team approach involving surgeons, gastroenterologists, interventional radiologists, and other specialists. Some of these complications require interventions and this is mainly for infected pancreatic necrosis and pseudocysts. For infected pancreatic necrosis, contemporary management includes the “Step-Up” approach as described in the landmark PANTER trial. This consists of percutaneous drainage followed, if necessary, by minimally invasive retroperitoneal necrosectomy, and lastly open necrosectomy. Open necrosectomy has been associated with high morbidity and mortality and is currently reserved for cases that are not amenable to, or that do not respond to either percutaneous catheter drainage or minimally invasive or endoscopic interventions. Finally, for pseudocysts, management usually involves EUS-guided drainage or surgical cystogastrostomy.