Acute pancreatitis is one of the most life-threatening urgent surgical diseases. Mortality rate in severe acute pancreatitis is still high. Nevertheless, mortality is being decreased over the past decades. Endogenous intoxication is the main pathogenetic factor caus-ing multiple organ failure in severe acute pancreatitis. Therefore, detoxification therapy is particularly important aspect in the complex treatment. Extracorporeal detoxification is potentially the most effective for endogenous intoxication and prevention of pro-gression of multiple organ lesion. To date, clear approaches to these techniques have not been formed in the early phase of dis-ease. We have analyzed literature data devoted to extracorporeal detoxification in severe acute pancreatitis and determined the recommendations for these techniques in intensive care.