The diagnosis of typical acute pancreatitis includes three major elements, namely, typical symptoms and signs, typical elevated blood and urine amylase and lipase, and typical imaging manifestations. However, clinically, due to the different time of consultation, different severity of the disease, different body size, age, tolerance of men and women, and whether there is an underlying disease, the three major elements may be atypical at the time of consultation, leading to misjudgment of physicians and patients, which leads to misdiagnosis and mistreatment, increasing the rate of death, disability and economic burden. For example, if a patient presents to the clinic for a few hours with abdominal pain, mildly elevated amylase and lipase, and abdominal ultrasound shows: significant intestinal distention, and no abnormalities in the liver, bile and pancreas, generally speaking, there are three conditions: 1. mild acute pancreatitis 2. early severe acute pancreatitis 3. other acute abdominal conditions, such as gastrointestinal perforation, acute cholecystitis, acute appendicitis, etc. Therefore, patients and their families must keep a clear head, and doctors must closely observe the changes in the condition and make a clear diagnosis by dynamic examination. Therefore, the diagnosis of acute pancreatitis is simple and complex. If all three major elements are typical at the time of consultation, there is not much problem in diagnosing acute pancreatitis, but if the three major elements are not typical, doctors and patients and families must keep a clear head, carefully analyze the causes, dynamically check blood biochemistry and imaging, especially enhanced CT examination, and remember not to make subjective assumptions. Second, the idea of diagnosis The diagnosis of acute pancreatitis should be three questions: The first question is whether it is acute pancreatitis? That is, whether there are three typical elements, paying special attention to the presence of atypical factors; the second question is whether it is severe acute pancreatitis? Particular attention should be paid to early severe acute pancreatitis; the third question is whether it is accompanied by underlying diseases? Such as various heart diseases, diabetes, hypertension, hyperlipidemia, etc. These diseases will affect the doctor’s technical judgment and treatment effect. In conclusion, atypical acute pancreatitis is easily misdiagnosed and mistreated, leading to patient death and increasing economic burden; dynamic examination, early diagnosis and early treatment is one of the key aspects of successful treatment of acute pancreatitis.