Objective: To observe the clinical efficacy of additive breviscapine in interventional selective arterial therapy for elderly patients with severe acute pancreatitis (SAP). Methods: Sixty elderly SAP patients (≥60 years of age) were randomly designated to observational group (32 cases) and control group (28 cases). Patients in control group underwent continuous regional pancreatic-arterial infusion of octreotide and antibiotics, while those in observational group received continuous regional pancreatic-arterial infusion of the above infusion drugs plus breviscapine. The clinical efficacies between the two groups were compared. Results: After 7-d treatment, the APACHE II scores in both groups were significantly decreased compared with those before treatment (both P<0.05), but were significantly lower in observational group than those in control group (P<0.05); the serum levels of tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6) in both groups were significantly decreased compared with those before treatment (all P<0.05), but the decreasing degree of the two factors in observational group were both significantly greater than those in control group (both P<0.05). The overall incidence of complications in observational group was significantly lower than that in control group (34.38% vs. 60.71%, P<0.05), and though the surgery conversion rate and mortality in observational group were lower than those in control group (12.5% vs. 21.5%; 9.38% vs. 14.29%), both differences reached no statistical significance (both P>0.05). Conclusion: Additive breviscapine in interventional selective arterial therapy has satisfactory efficacy for elderly SAP patients.