Methicillin resistant Staphylococcal aureus (MRSA) enterocolitis is characterized by high fever, abdominal distension, and watery diarrhea that leads to severe dehydration, shock, a sharp decrease in the white cell counts and sometimes multiple organ failure. Clinically, it can be an another cause of nosocomial diarrhea. If MRSA enteritis is suspected from the clinical symptoms, prompt treatment and strict prophylactic measures including vancomycin, are most important for its management. We recently observed a case of MRSA enterocolitis as a nosocomial infection in a patient with acute pancreatitis. This patient showed uncontrolled massive diarrhea, fever, and multiple organ failure. We report a case of MRSA enterocolitis with a review of literatures.