Objective To summarize the clinical profiles and treatment experience of severe hypedipidemic pancreatitis (SHLP).Methods A retrospective study was carried out to compare clinical characteristics on 22 cases of SHLP,and the serum and urine levels of amylase,triacylglycerol,Ranson scores,APACHE Ⅱ scores,Balthazar CT scores,incidences of circular,respiratory and renal insufficiency,pancreatic infection,pancreatic cyst,pulmonary infection and mortality were compared with those parameters of 91 patients with severe acute gallstone pancreatitis (SBP).Results The sermn and urine levels of amylase,triacylglycerol,Ranson scores,APACHE Ⅲ scores,Balthazar CT scores,incidences of circular,respiratory and renal insufficiency,pancreatic infection,pancreatic cyst,palmonary infection and mortality in SHLP group were (715 ± 99)U/L,(382±56)U/L,(17.8±6.2) mmol/L,5.22±0.33,14.65±2.91,5.85±1.17,36.4%,40.9%,22.7%,22.7%,22.7%,54.5% and 9.0%,respectively;the corresponding values of SBP patients were (1551±107) U/L,(773±66) U/L,(4.6±0.9)mmol/L,4.19±0.67,10.34±2.18,5.11±1.12,14.3%,6.6%,5.5%,23.1%,24.2%,31.9% and 12.1%,respectively.The levels of serum and urine amylase in SHLP were significantly lower than those of SBP.But SHIP patients had significantly higher incidence of circulation failure,respiration failure,renal failure and pulmonary infection.Conclusions In the process of diagnosis of SHIP,it should be noted that the elevation of blood and urine amylase may not be remarkable.In the management of SHLP,it was important to prevent and treat circular,respiratory and renal insufficiency.