Objective: To investigate the clinical efficacy of percutaneous catheter drainage (PCD) in the treatment of acute severe pancreatitis (SAP) complicated with peripancreatic necrosis and infection. Methods: The clinical data of 113 SAP patients with peripancreatic necrosis and infection (range of pancreatic necrosis<30%) undergoing surgical treatment were analyzed retrospectively. Of the patients, 54 cases received PCD treatment (PCD group), and 59 cases were subjected to direct open drainage (laparotomy group). The relevant clinical variables between the two groups of patients were compared. Results: There was no significant difference in white blood cell count, and levels of serum amylase, urine amylase, blood glucose and serum calcium between the two groups (all P>0.05), and all above parameters were significantly improved in both groups compared with their preoperative values (all P<0.05). Postoperative comparison showed that the levels of serum amylase, urine amylase and blood glucose in PCD group were significantly lower than those in laparotomy group (all P<0.05), and the length of hospital stay, hospitalization costs, mortality rate and treatment abandonment were significantly reduced in PCD group compared with laparotomy group (all P<0.05). The effective treatment rate (79.6% vs. 81.4%) and results of drainage fluid bacterial culture showed no significant difference between the two groups (all P>0.05). Conclusion: PCD has demonstrable efficacy in treatment of SAP complicated with peripancreatic necrosis and infection (range of pancreatic necrosis<30%), and also has advantages of short hospital stay and reduced hospitalization expense.