Background: Acute biliary pancreatitis (ABP) is a common gastrointestinal emergency caused predominantly by gallstones, particularly in Northern India where alcohol-induced cases are less frequent. Understanding the clinical profile and severity distribution is essential for improving diagnosis and management.

Objectives: To evaluate the demographic characteristics, clinical presentation, laboratory parameters, imaging findings, and severity of acute biliary pancreatitis in patients admitted to a tertiary care hospital in North India.

Methods: This prospective observational study was conducted at Dr. Rajendra Prasad Government Medical College, Kangra at Tanda, Himachal Pradesh, over a six-month period from July to December 2022. Fifty patients diagnosed with ABP were included using universal sampling. Data were collected on demographic variables, clinical symptoms, liver function tests (LFTs), and imaging results. Severity was classified based on the Revised Atlanta Classification.

Results: The mean age of patients was 53.04 ± 14.38 years, with a female predominance (64%). Abdominal pain was the most common symptom (100%), followed by vomiting (72%) and fever (30%). Based on severity, 54% had mild, 40% moderate, and 6% severe pancreatitis. Mean values of SGOT, SGPT, and ALP were 138.42, 120.88, and 143.74 IU/L, respectively. Ultrasonography revealed a bulky pancreas in 72% of cases, with 26% showing peri-pancreatic fluid collection.