Pancreatic necrosis,infection caused secondary sepsis of severe acute pancreatitis(SAP) can further cause septic shock and multiple organ failure,it is an important reason of death.The pathogenesis of SAP sepsis is still unclear,however,research shows that in SAP sepsis patients intestinal bacteria translocation is the main source of infection,the release of inflammatory medium causes persistent inflammatory reaction,microcirculation disorder and immune suppression promote the occurrence and development of SAP sepsis,and genetic polymorphism is closely related with susceptibility of SAP sepsis patients.Here is to make a review on the recent progress in pathogenesis of SAP sepsis.