Necrotizing pancreatitis (NP) is a severe complication of acute pancreatitis associated with high morbidity and mortality due to enzymatic tissue destruction, systemic inflammation, and the risk of infected necrosis. The article synthesizes knowledge about the pathogenesis, classification and epidemiology of NP with an emphasis on the prevention of infectious complications. Evidence supports a protective role of early enteral nutrition. The use of selective GI decontamination and antibiotic prophylaxis is debated because clinical trials and meta-analyses have inconclusive results due to heterogeneity in design, regimens, and patient selection. Recent advances include risk stratification using machine learning models to identify patients at high risk of infection. Prevention strategies should include nutritional support, judicious use of antimicrobials, and individual risk prediction. The efficacy of antibiotic prophylaxis remains controversial and requires further large-scale studies on standardized protocols.