Classification of patients with chronic pancreatitis remains difficult because of the heterogeneity in clinical course and progression as well as inconsistent correlation of radiographic changes with patient presentation. Many classification systems have been proposed, but no single system has become widely accepted and used in clinical practice. The proposed classification systems are limited because of their focus on radiographic changes or narrow patient populations, the complexity of the classification system, and/or the lack of prospective multi-institutional validation. Medical management of chronic pancreatitis is also a challenge owing to a wide spectrum of clinical presentations. Medical management focuses on pain control, modification of risk factors for future acute episodes, correction of nutritional deficiencies, and management of exocrine and endocrine dysfunction. Given the lack of a widely used classification system, medical management of chronic pancreatitis remains somewhat individualized, although recommendations do exist for escalation of pain management and pancreatic enzyme replacement. Here, we summarize nine of the proposed classification systems for chronic pancreatitis (Marseille, Cambridge, Rosemont, TIGAR-O, M-ANNHEIM, ABC, Manchester, Heidelberg, and Chronic Pancreatitis Prognosis Score) and discuss some of the strengths and limitations of these systems. We also describe the components of medical management of chronic pancreatitis.