Chronic pancreatitis is an inflammatory disease which is characterized by irreversible morphologic changes that typically causes pain and permanent loss of the functions. The lack of good treatment options for patients with chronic pancreatitis is in part is related to any therapy needing to address the “3Ps” that are necessary for this disorder.1) Pain relief, 2) Prevention of brittle diabetes mellitus and 3) Prevention of pancreatic cancer. Total pancreatectomy and autologous islet cell transplant (TP-AIT) does offer a definitive therapy while addressing these three; however there has not been a universal uptake of this treatment to consider it the standard of care due to it being considered highly invasive and success being measured mainly by the concept of the length of insulin independence. However diabetes is an endpoint of chronic pancreatitis and this procedure offers the possibility of glycemic control albeit with some insulin use and therefore offers the best alternative to a life of pain, diabetes and cancer.