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Introduction: Management and prognosis of patients with acute pancreatitis (AP) vary depending on the different etiologies. Differences in management and outcomes based on whether a patient is admitted to a medical or surgical service may exist, but few studies have addressed this issue. Our aim was to analyze the effect of medical or surgical admission on management and outcomes of AP. Methods: We conducted a retrospective review of all patients admitted to a single institution with a diagnosis of acute pancreatitis during January 2007 and June 2008. Clinical, biochemical, demographic, management and outcome variables were obtained. Descriptive statistics were used according to the type of variable measured. The statistical significance of the associations was evaluated by the χ2 test and Fisher's exact test where appropriate. For continuous variables, Student's t test was performed.Results: Eighty-one consecutive patients were included and analyzed. Fifty-three patients (65%) were female. Forty-seven (58%) were admitted to a surgical service (SS) and 34(42%) to a medical service (MS). Mean age of patients admitted to a SS was 37.2 ± 14.95 vs. 39.2 ± 17.48 (P=0.5). Etiologies were as follow, 48(59%) biliary, 9(11%) alcoholic, 11(14%) hypertriglyceridemia and 13(16%) idiopathic. Most cases of biliary pancreatitis (94%, P=0.0001) were managed in a SS. Using APACHE II, 63(78%) patients were classified as mild pancreatitis and 18(22%) as severe [8(17%) in SS vs. 10(29%) in MS (P=0.2)]. Patients with a diagnosis of diabetes mellitus (DM) were more frequently admitted to MS 11(32%) than to SS 4(8.5%) (P=0.009). Other co-morbidities were also more frequent in MS (P=0.0001). Seventy-two percent of patients admitted to a SS received antibiotics during hospitalization compared to 53% of those in MS (P=0.1). Total parenteral nutrition (TPN) was used in 11% of patients in SS and 6(18%) in MS, (P=0.5). A nasogastric tube (NG) was placed in 17% of patients in SS vs. 15% in MS, (P=1). Patients with DM had significantly more severe AP than non-DM patients (P=0.003), however, mortality was not significantly different among DM and non-DM patients (P=0.1). Length of stay (LOS) was 7.94 days in SS vs. 8.53 days in MS, (P=0.6). Overall mortality was 9% (7/81), 4/43 in SS vs. 3/31 in MS (P=0.6).Conclusions: At our institution, surgical services tend to use more antibiotics and treat patients with less co-morbidity than medical services. Despite minor variations in management of AP and different etiologies among surgical and medical services, outcomes are not significantly different.