Increased urinary amylase is commonly seen in acute pancreatitis, but can also be seen in pancreatic cancer, parotitis, and perforated peptic ulcers, and should be analyzed on a case-by-case basis. Amylase comes primarily from pancreatic and parotid tissue, and urinary amylase can be elevated when lesions occur in these two areas. Amylase can be detected in the blood and urine, and generally blood amylase increases early and lasts a short time, while urine amylase increases late and lasts a long time. Elevated urinary amylase is commonly seen in acute pancreatitis and usually begins to rise around 24 hours, peaks in 48 hours, declines slowly, and returns to normal in 1 to 2 weeks. Patients have severe, progressive epigastric pain that may radiate to the back and may be accompanied by nausea and vomiting. The magnitude of amylase elevation does not correlate with the severity of the disease, but a higher elevation often means a more correct diagnosis. Elevated urinary amylase can also be seen in other pancreatic diseases such as acute exacerbations of chronic pancreatitis, pancreatic duct obstruction, and pancreatic cancer. Urinary amylase can also be elevated in other non-pancreatic conditions such as mumps, perforated peptic ulcers, postoperative epigastric surgery, mechanical intestinal obstruction, and acute cholecystitis. To summarize, there are many factors leading to elevated urinary amylase, and one should go to the hospital to improve the examination, clarify the cause of the disease, and then choose the appropriate treatment.