Chronic pancreatitis (CP) is due to persistent inflammation, fibrosis, and irreversible cell damage to the pancreas, resulting in a loss of endocrine and exocrine gland function. Irreversible damage distinguishes CP from acute pancreatitis, in which the damage is reversible. The most common etiologies are alcohol abuse and pancreatic duct obstruction, and there is a strong association with cigarette smoking. Patients often present with recurrent epigastric abdominal pain, nausea, and features of malabsorption syndrome (diarrhea, steatorrhea, and weight loss). Characteristic computed tomography (CT) findings depend on the severity and range from mild ductal dilatation and gland enlargement to severe ductal dilatation, large cavity formations, and calcifications. Therapy focuses on alcohol cessation, diet changes, pain management, and treatment of pancreatic insufficiency. Endoscopic or surgical decompression of large ducts may be necessary, and patients who have intractable pain with small duct disease may require pancreatic resection.