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SUMMARY Massive haemorrhage in pancreatitis is a very rare complication of pancreatitis but it is the most rapidly lethal, haemorrhage being the major cause of death in more than half of the fatal cases. We present three patients who illustrate this rare complication in its diversity of presentation, and advise that doctors should have a keen clinical awareness of this condition if there is to be an effective and expeditious management. An understanding of the condition, coupled with immediate treatment, using embolisation or laparotomy with direct ligation of the bleeding vessel, can be lifesaving.