Abstract：Objective：To discuss the value of CT in evaluation of prognosis and the curative effect of integrated Chinese and western medicine therapy in treatment of severe acute pancreatitis(SAP). Methods：A total of 100 cases of SAP patients were selected and divided into the experiment group and the control group according to the random number table method， 50 cases in each group. The control group was given routine symptomatic treatment and nutritional support， and the experiment group was additionally given Qingyi tang based on the treatment of the control group. Both groups were treated for two weeks. The clinical effect， the fatality rate， CT density， and the score of extrapancreatic inflammation were compared between the two groups. Results：The total effective rate was 90.00% in the experiment group，higher than that of 74.00% in the control group(P＜0.05). After treatment，in the experiment group，the fatality rate of grade Ⅲ by Balthazar CT classification was 8.33%，the fatality rate of grade Ⅳ was 11.76%，and the total fatality rate was 8.00%；in the control group，the fatality rate of grade Ⅲ by Balthazar CT classification was 16.00%，the fatality rate of grade Ⅳ was 27.78%，and the total fatality rate was 18.00% ； there was significant difference being found in the comparison of the total fatality rate between the two groups(P＜0.05). After treatment，CT density in the experiment group was larger than that in the control group(P＜0.05)， and the score of extrapancreatic inflammation was lower(P＜0.05). Conclusion： In the treatment of SAP， integrated Chinese and western medicine therapy can effectively improve clinical symptoms and reduce the fatality rate. CT examination can effectively assess prognosis and the curative effect of integrated Chinese and western medicine therapy in treatment of SAP.