Introduction: Pancreatitis is uncommon in children. The incidence is higher in chronic renal failure, hemodialysis, and chronic ambulatory peritoneal dialysis(CAPD) patients and accompanied with late complications including pancreatic necrosis, pseudocyst and abscess. Case Report: We report a 5 year old girl with end stage renal disease due to focal segmental glomerulosclerosis, being on CAPD for two years. She was admitted for intermittent severe epigastric pain of four months duration, hypotension, severe cachexia and cloudy drained dialysate with negative culture and mild increment serum amylase. On abdominal imaging a pancreatic cyst was reported which was an infected cyst on laparotomy. Despite drainage of suppurative fluid and antibiotic therapy, the patient expired with severe sepsis and multiorgan dysfunction two weeks after operation. Conclusion: The presence of poor weight gain, unexplained abdominal pain and cloudy drained dialysate in children on CAPD may suggest pancreatitis. Frequent evaluation of pancreatic function and sonography is recommended.