Objective: To evaluate the efficacy and safety of peritoneal lavage in the management of severe acute pancreatitis(SAP). Data sources: We searched the Cochrane Central Register of Controlled Trials (CCTR) on The Cochrane Library issue 1, 2009 Medline(Pubmed) EMbase CBM,CNKI,VIP and wangfang. Randomized clinical trials, in which peritoneal lavage were compared to other intervention in patients with severe acute pancreatitis. Review methods: Full-text articles of the studies that met all the inclusion criteria were retrieved.The data were abstracted independently by two reviewers. We used I2 and ?2 measures to assess heterogeneity.Random effects models were applied. Methodological quality of included studies was assessed according to the criteria of Cochrane Collaboration.We used the Cochrane RevMan 5.0.17 for Meta-analysis. Main results: Ten studies, encompassed a total of 469 patients including 219 patients were included and analysed. There was no statistically significant difference on mortality and complications between Peritoneal lavage versus conservative treatment;Peritoneal lavage versus pancreatic resection;Long peritoneal lavage versus short peritoneal lavage;Long peritoneal lavage versus short peritoneal lavage;Peritoneal lavage with antiproteases versus peritoneal lavage only. Conclusion: This systematic review shows that the use pertitoneal lavage in patients with severe acute pancreatitis does not result in a reduced morbidity and mortality.