Acute pancreatitis (AP) is a rare entity in pregnancy, mainly caused by gallbladder disorders, in which symptoms of cholelithiasis and biliary sludge in many cases precede the symptoms and clinical picture of AP. Diagnosis is based on clinical presentation, laboratory investigations and imaging methods performed with precaution because of potential radiation risk to the fetus. General management of mild AP in pregnancy is conservative and supportive, while severe AP deserves hospitalization in intensive care unit and endoscopic or surgical interventions. The most common in pregnancy - biliary AP, can be resolved with urgent ERCP sphincterotomy and laparoscopic cholecystectomy preferably in second trimester, when technical conditions are optimal and risk for fetus and pregnant woman minimized. Although treatment of AP during pregnancy is similar to general approach in AP patients, a multidisciplinary team consisting of gastroenterologist, gastrointestinal surgeon, radiologist and obstetrician should be included in the treatment and follow up of these patients. The majority of cases of AP are biliary in origin, and they are associated with better outcomes than non-biliary causes.