Abstract: Objective: To compare the clinical characteristics of hyperlipidemic acute pancreatitis(HLAP) and acute biliary pancreatitis(ABP),and improve the diagnosis and treatment of HLAP.Methods: Eighty-eight patients with pancreatitis were divided into the HLAP group(28 cases) and ABP group(60 cases) according to the pathogeny.The general clinical data,main biochemical index,imaging data,accompanying disease,mortality and recurrence rate between two groups were compared.Results: The hyperlipidemia pancreatitis complicated with fatty liver,diabetes mellitus,severe pancreatitis and recurrence rate in HLAP group were more than those in ABP group(P<0.05-P<0.01),but the APACHEⅡ and the incidence of severe acute pancreatitis were higher than in ABP group.Conclusions: The HLAP patient has unique clinical characteristics,and its clinical manifestation is not typical,which complicated with foundation disease is more and easy to recur.In addition to the conventional treatment,quick reducing the blood lipid level is the key of treatment as soon as possible.