Orlistat is a pancreatic lipase inhibitor which is used to treat obesity. Due to the increasing prevalence of obesity, orlistat use is thought to rise progressively. The indications of orlistat are body mass index (BMI) >30 without any risk factors or BMI >27 with additional risk factors such as hypertension, hyperlipidemia or diabetes . Orlistat has been reported to be associated with adverse events such as hepatic cholestasis, subacute hepatic failure and hepatic necrosis. However, placebo-controlled studies have shown no relationship with acute pancreatitis. Only four cases of acute pancreatitis associated with orlistat have been reported in the literature, and one of those cases did not demonstrate an increase in serum amylase . We report an interesting case caused by orlistat use caught in the early stages of acute pancreatitis through imaging; in addition, the case had significantly elevated serum amylase levels