Objective To systematically evaluate the efficacy of magnesium sulfate combined with conventional treatment in the treatment of severe acute pancreatitis(SAP).Methods Randomized controlled trial(RCT)comparing the efficacy difference between conventional treatment and conventional treatment combined with magnesium sulfate in the treatment of SAP were included by searching PubMed,Web of Science,CNKI and WanFang data knowledge service platform from the establishment of the database to July 1,2022.Meta-analysis was performed by Review Manager 5.4software to evaluate the prognosis of patients.Results Compared with the conven-tional treatment(water fasting,gastrointestinal decompression,fluid replacement,antibiotic treatment,inhibition of pancreatic enzyme se-cretion,maintenance of water,electrolyte and acid-base balance),magnesium sulfate combined with conventional treatment can reduce the mortality and complications related to SAP,and shorten the length of hospital stay,relief time of abdominal pain,duration of fever.Conclusion Magnesium sulfate combined with conventional treatment is superior to conventional treatment in improving the mortality,complication rate,length of hospital stay,relief time of abdominal pain,duration of fever in patients with SAP.