What is "Use Cron Based Sending" set to? If it's yes, then the problem could be that the scheduled task isn't running. Maybe try setting it to "no" and seeing if the queue starts going down (either way it depends on traffic comng to your site).
It could also be that someone's sending a lot of emails out that you aren't aware of (if you have permissions set to allow users to send email to other users). Unfortunately there's really no interface to see what's going on in the queue, you'd have to query the database and look at the mailqueue table. I have to be honest - I've heard people mention an email log but I don't know offhand how you get to it.
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