Acute biliary pancreatitis may be a grave illness with a fatal outcome in some instances. Its etiology is unclear so far. The diagnosis is difficult even with the help of conventional diagnostic methods and the most up to date imaging techniques. The most sensitive method among laboratory investigations is the elevation of ALT (serum alanine transferase) while endoscopic cholangiopancreatography has the highest accuracy rate of invasive diagnostic procedures. There is a chance of spontaneous remission in cases with mild symptoms while invasive measures-endoscopy or surgery-are needed in cases with grave symptoms. In the present study we evaluate 23 of our cases.