Objective: To investigate the clinical efficacy and safety of endoscopic ultrasound (EUS)-guided puncture and drainage in treatment of infectious pancreatic necrosis (IPN). 
Methods: The clinical data of 60 patients with IPN undergoing EUS-guided puncture and drainage from January 2013 to December 2018 in the Third Xiangya Hospital of Central South University were retrospectively analyzed. The main vital signs, intraabdominal pressure (IAP), relevant clinical scores, laboratory results of the patients before and after treatment were compared, and the postoperative complications and followed-up of the patients were also analyzed.  
Results: In all patients after EUS-guided puncture and drainage, the vital signs, IAP, clinical scores and laboratory findings were significantly improved compared with those before treatment (all P<0.05). The treatment results were assessed as cure in 10 cases (16.7%), significantly improved in 46 cases (76.6%) and failed in 4 cases (6.7%). The overall effective rate was 93.3%. The incidence of serious complications was 16.7%, including pancreatic fistula in 3 cases, extraintestinal fistula in one case, intestinal perforation in 3 cases and hemorrhage in 3 cases. No procedure-related death occurred in any of them. Follow-up was obtained in 56 patients, and among them, the necrotic lesions were almost completely absorbed in CT scan, the clinical symptoms disappeared and the laboratory indexes showed no obvious abnormal results in 34 cases (60.7%), pancreatitis recurrence occurred within half a year in 10 cases, exocrine pancreatic insufficiency developed in 7 cases, and 4 cases died. 
Conclusion: EUS-guided puncture and drainage has excellent clinical efficacy and safety in treatment of IPN.