Abstract: Objective To investigate the pathogenesis and therapeutic strategies of acute pancreatitis in pregnancy (APIP). Methods A retrospective analysis was performed in terms of the characteristics, treatment managements, and clinical outcomes in 12 patients with APIP admitted to Chinese PLA General Hospital from January 2010 to November 2014. The control group consisted of 24 acute pancreatitis patients without pregnancy aged 22-39 years during the same period. Results The content of serum triglyceride in APIP group was significantly higher than control group (4.62±5.21) mmol/L vs (1.91±1.90) mmol/L, P=0.003. However, there were no differences between two groups in white blood cell count, hemoglobin concentration, serum total cholesterol, serum calcium and fasting blood glucose. Also, there were no significant differences in the incidence of premorbid high-fat diet, as well as in the incidence of cholecystolithiasis and length of stay in hospital between two groups. In APIP group, 10 patients were cured clinically without any complications, one case was complicated with pancreatic pseudocyst as well as secondary diabetes mellitus, and one patient died of multiple organ dysfunction syndrome (MODS). One case had a fetal death due to intrauterine distress followed by cesarean section, one case underwent labor induction in the course of pancreatitis and one case requested automatic termination of pregnancy after she was cured. Nine infants survived. Conclusion Hyperlipidemia may be one of the risk factors in pathogenesis of APIP. It is necessary to monitor blood lipid and pay attention to diet, especially in avoiding excessive tonic. Clinicians need to take both mothers and fetuses into consideration for individualized treatment.