Chronic pancreatitis can be very difficult to manage with both physiologic and psychological elements to the care of the patient affected. Chronic pain is a common theme with patients affected by chronic pancreatitis. Surgical treatment with either resection or drainage has been the backbone of interventional therapy for these patients. However, choice of the right patient and the correct intervention is not easy and is the main topic of this chapter. Resection options, such as the Whipple or distal pancreatectomy, will be discussed. Drainage options will be covered also. There will be special attention to combined resection and drainage (including the “Whip-Stow procedure”) that is favored by the authors.