ObjectiveTo investigate the clinical and prognostic features of hypertriglyceridemic pancreatitis (HTGP) during pregnancy. MethodsA total of 77 patients with acute pancreatitis in pregnancy who were admitted to The Affiliated Hospital of Southwest Medical University from January 2013 to June 2020 were enrolled as subjects, and according to the presence or absence of HTGP, they were divided into HTGP group with 38 patients and non-HTGP group with 39 patients. The two groups were compared in terms of the clinical features including age, pregnancy, laboratory markers, complication, and prognostic indices. The independent samples t-test was used for comparison of normally distributed continuous data between two groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups; the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups, and the Mann-Whitney U test was used for comparison of ranked data between two groups. According to the trimester of pregnancy, the patients were divided into early pregnancy group with 4 patients, middle pregnancy group with 14 patients, and late pregnancy with 59 patients, and blood lipid levels were compared between groups; the Kruskal-Wallis H test was used for comparison between two groups or within each group. ResultsCompared with the non-HTGP group, the HTGP group had significantly higher mean age (t=-3.000, P=0.004) and proportion of patients with diabetes (χ2=8.867, P=0.003). Compared with the non-HTGP group, the HTGP group had a significantly higher proportion of patients with disease onset in the third trimester (P＜0.001) and a significantly lower serum level of sodium (Z=-6.328, P＜0.001). Compared with the non-HTGP group, the HTGP group had significantly higher incidence rates of acute peripancreatic fluid collection (76.3% vs 33.3%, χ2=14.342, P＜0.001) and systemic inflammatory response syndrome (81.6% vs 410%, χ2=13.310, P＜0.001). There were significant differences between the two groups in the length of hospital stay, the rate of admission to the intensive care unit, and hospital costs (Z=-2.077, χ2=11.537, Z=-3.525, all P＜0.05). The levels of total cholesterol and triglyceride in the third trimester were significantly higher than those in middle pregnancy (both P＜0.05). ConclusionCompared with the non-HTGP group, the HTGP group has a higher proportion of patients with disease onset in the third trimester of pregnancy, a higher risk of complications, a longer length of hospital stay, and higher hospital costs.