Purpose: The purpose of this research was to assess the preferred route of nutrition support (enteral versus parenteral) for treatment of severe acute pancreatitis in the acute care setting. Further, in cases when enteral nutrition is the preferred route, is nasal-bridling a lower-morbidity and cost-effective method? Design/methodology/approach: A retrospective review of pre-existing data from an 870-bed hospital system. Medical records were reviewed via an online database system (n=25\; patients) with severe acute pancreatitis. Length of stay and cost were analyzed. Findings: More patients received TPN versus the nasal-jejunal (post-pyloric) tube feeds group. No significant relationship was found between total cost and number of co-morbidities or between either of the two treatment groups. However, a medium to large effect size was shown which could indicate a significant relationship in a larger sample size. Originality/value: The findings of this research add to the literature already available and will be of interest to those who specialize in this area. © Emerald Group Publishing Limited.