Patients with abdominal pain resulting from pancreatitis are often misdiagnosed initially. There are no pathognomonic physical signs to implicate the pancreas as a source of chronic abdominal discomfort. Four patients seen consecutively (and one studied retrospectively) illustrate that erythema ab igne of the abdomen or low back may be a sign of pancreatitis. These patients had used heat on their abdomens or backs in attempts to relieve the pain. Using heat in this manner is common among patients with undiagnosed pancreatitis; the heat enhances the appearance of the erythema ab igne. The presence of pigmentation is a sign of organicity which should lead the physician to investigate the pancreas as a source of the patient's pain.