The aim of the study was to investigate the role of early multiple organ failure in 152 patients with severe acute pancreatitis admitted to the intensive care unit for the period from 2002 to 2009. The group of patients with early progressive multiple organ failure had high early (29%) and overall mortality (45%) rate, infectious complications rate (39%) and long intensive care unit stay (median - 8 (5; 18) days). Based on the statistical analysis of data the criteria to predicted risk progression of multiple organ failure on admission were: APACHE II score ≥12, SOFA score ≥4, failure >2 organs/systems, Ranson score ≥7.