Objectives: The incidence of pediatric acute pancreatitis (AP) increased over the past 2 decades and is estimated to be 3 to 13 per 100,000. The impact of rising AP incidence on health care costs is unknown. Our aim was to examine pediatric AP admissions and associated hospital costs in the United States between years 2004 and 2014.Methods: Acute pancreatitis admission and cost data were extracted from the Pediatric Health Information System. We determined AP admission and cost percentages each year, as well as the ratio of AP cost to admission percentages to estimate AP “burden.” Length of stay, costs of hospitalization, and the effect of intensive care unit care on these estimates were examined.Results: Between 2004 and 2014, AP admission percentages increased (P= 0.002). Length of stay decreased over time (P< 0.0001) and was longer for those requiring intensive care unit care (P< 0.0001). Acute pancreatitis admissions cost per day significantly increased over time (P< 0.0001). Median AP cost percentage remained 1.2 to 1.7 times higher than AP admission percentage.Conclusions: Acute pancreatitis admissions constitute an expensive burden on the health care system relative to the percentage of all admissions. If AP admissions continue to increase, the cost of AP admissions may pose a substantial financial health care burden.