Pancreatic or peri-pancreatic necrosis complicates about 20% of all acute pancreatitis (AP) episodes with infected necrosis associated with a higher mortality rate of 10-30%. Current evidence-based guidelines recommend that infected pancreatic necrosis (IPN) should be managed with a step-up approach. With increasing use of minimally invasive approach, the optimal timing of drainage is still debated. There is widespread agreement that delayed drainage of infected necrosis > 4 weeks is favoured to ensure clinical success and safety. Earlier intervention can be considered in selected patients with ongoing clinical deterioration, and recognition of these patients is essential. Management of these patients require an intensive multidisciplinary approach in a specialised HPB centre.