Acute pancreatitis (AP) is a condition in which the abnormal activation of pancreatic enzymes in the pancreas leads to digestion of the pancreas itself and surrounding organs, characterized mainly by local pancreatic inflammation, which can cause organ dysfunction and acute abdominal pain in severe cases. In the progression of AP, microcirculatory disturbances can lead to intestinal ischemia and hypoxia, which further causes epithelial damage, limiting the balance of gut flora and affecting the basic immune system. The gut barrier requires a continuous cellular layer and matrix connections. In the pathogenesis of AP, the integrity of this gut barrier is disrupted, which causes gut flora to shift to other organs, a decrease in beneficial bacteria, and further harm to patients, resulting in systemic inflammatory response syndrome (SIRS), multiple organ dysfunction syndrome (MODS), and even death. In recent years, domestic and foreign scholars have paid increasing attention to the improvement of the gut environment to alleviate the development of AP. In the treatment of AP patients, supplementing probiotics can protect and repair the intestinal mucosal barrier of AP patients, while reducing the chance of gut flora translocation and improving gut microecology, which provides new ideas for the treatment of AP.