Background and Aim: Acute pancreatitis (AP) is a common disease, with incidence of 15.9 cases per year for each 100,000 inhabitants in Brazil. The treatment of AP remains controversial in some topics, due mainly to difficulties to develop clinical studies. We hypothesized that high volume AP surgeons could have more updated concepts to treat AP, promoting better results than low-volume AP surgeons. Our aim is to compare low-volume with high-volume surgeons regarding concepts in the management of AP. Methods: A questionnaire has been sent to 2,000 members of the Brazilian College of Surgeons, with 618 (30.9%) answers obtained. The questionnaire consisted of questions related to the surgeon experience and in particular to the treatment of AP. Then we compared concepts of management of AP between surgeons who attend up to 10 patients with AP per year (Group A - n=329), with surgeons who attend more than 10 patients with AP per year (Group B - n=212). Questionnaires from surgeons who do not treat AP were excluded. Difference between groups was determined by Fisher test, with p<0.05 as significant.Results: The comparison between group A and Group B showed that in Group B surgeons believe more often than Group A that CT should be done following severity criteria (36.1% vs. 56.2%, group A and B, respectively, p<0.001) instead of perform a CT in all patients (58% vs. 41.4% (group A and B, respectively, p<0.001). In Group A, 56.2% and 38.1% in Group B believe that parenteral nutrition is the best way to feed patients with acute pancreatitis (p=0.002). Enteral nutrition alone is the method of choice to nutritional support to 22.7% in group A and 32.9% in group B (p=0.012). Regarding surgical treatment, 60.6% in Group A against 44.3% in Group B believe that the best period of time to operate a patient with AP is up to 14 days (p<0.001). In Group A, 33.5% of surgeons give antibiotics to all patients with AP, in opposition to 16.7% in Group B (p<0.001). Conclusion: We conclude that high-volume pancreatitis surgeons make a difference regarding concepts of management in AP, that could be implicated in a better treatment of these patients. Thus, patients with severe AP should be treated preferentially in high-volume centers.