Pancreatic amylase 78500U/L may be due to pancreatic diseases such as pancreatitis, pancreatic cancer, or non-pancreatic causes. The normal reference value of pancreatic amylase is 35~135 U/L in blood and less than 1000 U/L in 24-hour urine, so reaching 78,500 U/L is a significant elevation of amylase, which is most common in pancreatic diseases such as pancreatitis and pancreatic cancer. Elevated amylase may also be seen in non-pancreatic diseases such as mumps, perforated peptic ulcers, acute cholecystitis, ethanol intoxication, and macroamylasemia. In conclusion, pancreatic amylase 78500U/L, it is recommended that CT and other imaging and pathologic examinations should be completed as soon as possible to clarify the etiology and take targeted diagnosis and treatment.