【Abstract】Objective To study the effects of combined detection of lactate, Ddimer (DD) and fibrinogen (FIB) in severity and prognosis evaluation of acute hyperlipidemic pancreatitis (HLAP). Methods 143 patients with HLAP treated between March 2018 and March 2020 were divided into mild acute pancreatitis (MAP) group, moderate severe acute pancreatitis (MSAP) group and severe acute pancreatitis (SAP) group according to the severity of the disease. The levels of lactate, DD and FIB in patients with different severities of HLAP and different prognosis were compared. The receiver operating characteristic (ROC) curve was used to analyze the value of lactate, DD and FIB in severity and prognosis prediction of HLAP. Results The lactic acid, DD and FIB levels of the three groups were significantly higher than those of the MAP group and the MSAP group (P＜005). The levels of lactate, DD and FIB were significantly higher in SAP group than MAP group and MSAP group, significantly higher in MSAP group than MAP group (P＜005), and significantly higher in death group than survival group (P＜005). The area under the curve (AUC) values of DD for predicting the severity and prognosis of HLAP were the highest (0886, 0831). When the cutoff values were 0899mg/L and 0963mg/L, the sensitivities were 7742% and 8182%, specificities were 9732% and 8864%. The AUC values of joint prediction for the severity and prognosis of HLAP were 0927 and 0851. The sensitivities were 8065% and 9091%, and the specificities were 9196% and 7724%. Conclusion Lactate, DD and FIB can be used as sensitive indexes for predicting the severity and prognosis of HLAP. For single detection, the performance of DD is the best. The combined prediction can further improve the prediction performance and is worthy of clinical promotion.