Objective:To study the clinical features of hyperlipidemic severe acute pancreatitis.Methods:From January 2 000 to June 2008, 114 cases of severe acute pancreatitis treated in our hospital were divided into hyperlipidemia group(HLgroup,21cases) and nonhyperlipidemia group(NHLgroup,93 cases).Clinical features, complications, and outcome were assessed and compared.Results:There were no differences in gender composition, age and ranson score (P＞0.05), between the two groups,but in body mass index ［(24.451±3.752) vs (22.468±2.434), P=0.030］, previous history of pancreatitis (23.8% vs. 7.5%, P=0.046) and bloody ascites (95.24% vs. 46.24%, P<0.001) in HLgroup were higher than those in NHLgroup. The rates of the complications,such as abdominal abscess, ARDS, renal failure, stress ulcer, DIC,and pseudocyst were of no statistical difference between the two groups(P＞0.05). MODS rate was higher in HLgroup (52.4% vs. 29%, P=0.04). The two groups had similar operation rates(66.7% vs 80.6%, P=0.178), hospitalization days ［(25.476±14.383) vs (22.796±7.191), P=0.216］ and mortality rate (28.6% vs.11.8%, P=0.069).Conclusions:Hyperlipidemic severe acute pancreatitis has the characters of heavier weight habitus,history of frequent recurrence,high incidence of bloody ascites and prone to develop MOF.