Background: Acute pancreatitis (AP) is an inflammatory condition with a variable clinical course, requiring early diagnosis and severity assessment for optimal management. Biochemical markers such as serum amylase and lipase are widely used, though their limitations necessitate adjunctive tools. Aim: To evaluate the diagnostic utility of serum amylase, serum lipase, and the amylase–lipase ratio in patients with acute pancreatitis. Methods: This prospective study included 90 patients diagnosed with AP between June 2025 and February 2026 at Sree Mookambika Institute of Medical Sciences Diagnosis was based on standard clinical, biochemical, and radiological criteria. Serum amylase and lipase levels were measured, and the amylase–lipase ratio was calculated. Statistical analysis was performed using Statistical Package for the Social Sciences. Results: The study population showed male predominance (73.3%) with a mean age of 38.5±2.25 years. Elevated serum amylase and lipase levels were observed in 75 and 73 patients, respectively, while a subset had normal enzyme levels. The mean serum amylase and lipase levels were 870.3±754.23 IU/L and 235.8±124.5 IU/L. An amylase–lipase ratio >3 was seen in 54 patients, suggesting alcoholic etiology. At three times the upper limit of normal, sensitivity and specificity were 83.33% and 84.88%, respectively, with an overall diagnostic accuracy of 84.09%.

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