5-aminosalicylic acid has been reported to be able of inducing acute pancreatitis as an adverse reaction. However, in most case reports, rechallenge of the drug is missing; therefore, evidence is still needed to confirm its role in the clinical course of acute pancreatitis and its influence on the outcome. Here, we report a case of recurrent acute pancreatitis secondary to 5-aminosalicylic acid, with positive unintentional rechallenge. A systematic search of the literature was performed and 42 cases from 35 articles were summarized concerning the clinical course of 5-aminosalicylic acid induced acute pancreatitis. Key words: acute pancreatitis – 5-ASA – 5-aminosalicylic acid – rechallenge – drug-induced – adverse drug reaction – Crohn’s disease. Abbreviations: 5-ASA: 5-aminosalicylic acid; AP: acute pancreatitis; CRP: C-reactive protein; CMV: cytomegalovirus; HIV: human immunodeficiency virus; HHV: human herpes virus; ERCP: endoscopic retrograde cholangiopancreatography; DIAP: drug-induced acute pancreatitis; MRCP: magnetic resonance cholangiopancreatography; ADR: adverse drug reaction.