Abstract : To assess the clinical profile and the efficacy of various severity indices in predicting the outcome of patients with acute pancreatitis. This was a prospective study done in a tertiary medical college and hospital during the study period. Along with routine lab parameters, serum amylase, lipase, lipid profile, calcium, CRP, LDH, CT abdomen were done for all patients with acute pancreatitis. A total of 150 patients were analysed. 54 (26%) patients required Intensive care, among them 9 patients (22.2 %) died. 24 patients (16%) had MODS, 18 patients (12%) had pleural effusion, 12 patients (8%) had pseudocyst, 5 patients (3.3%) had hypotension, 5 patients (3.3%) had ARDS and 5 patients (3.3%) had DKA. It is seen that morbidity & mortality was more with high CT severity index, CRP & LDH. 21 patients (14%) underwent open necrosectomy surgery, 7 patients (4.6%) underwent laparoscopic necrosectomy and 12 patients (8%) were tried step up approach but could not avoid surgery. No significant reduction in mortality was seen with surgical intervention. In acute pancreatitis, initial assessment of serum lipase level, CRP & LDH could be reliable indicators of outcome of patients.