ObjectiveTo evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for pancreas divisum（PD）with chronic pancreatitis (CP) in adults. MethodsData of patients older than 18 years old diagnosed as having PD with CP in Hangzhou First People''s Hospital from January 2008 to January 2020 were retrospectively analyzed, i.e.the general information, ERCP procedures and follow-up data of the patients. The number of acute pancreatitis attacks, visual analogue scale (VAS) of abdominal pain, and the diameter of pancreatic duct before and after ERCP were compared. ResultsA total of 61 patients diagnosed as having PD with CP underwent 301 ERCP procedures with the median number of 4(3.0-6.5). The median number of pancreatic stent replacement was 3 (2-6). The success rate of the first minor papilla cannulation was 90.2% （55/61）, and the total success rate of minor papilla cannulation was 98.0% （295/301）. The efficacy rate of the first ERCP was 82.0% （50/61）. ERCP-related complication rate was 2.7% （8/301）. The median follow-up time was 54 months (31.0-97.5 months). The median number of acute pancreatitis attacks decreased from 2.40 to 0 (Z=-6.726, P<0.001) compared with that before ERCP. The median VAS decreased from 7 to 2 (Z=-6.621，P<0.001). The median pancreatic duct diameter decreased from 5.0 mm to 4.0 mm (Z=-2.330， P=0.020). However, the mean weight increased from 56.04±10.75 kg to 58.62±10.79 kg （t=-5.285，P<0.001）one year after the procedure. ConclusionERCP is safe and effective in the diagnosis and treatment of PD with CP in adults.