The treatment of patients with autoimmune pancreatitis poses a challenge to the clinician. Prednisone, in an initial dosage of 30 to 40 mg/d, is used in patients with moderate abdominal and back pain, obstructive jaundice, or sclerosing cholangitis. Antacid or anticholinergic agents may be used to minimize stimulation of pancreatic exocrine function. Patients with quiescent disease may not need pharmacologic medication. In patients with complications such as obstructive jaundice and infection, biliary drainage and administration of antibiotics are recommended prior to steroid therapy. Steroid therapy occasionally ameliorates diabetes mellitus associated with autoimmune pancreatitis.