Background: Acute pancreatitis is a complicated illness with a wide range of local and systemic consequences that surgeons throughout the world deal with. This study evaluated the etiology and clinical presentation of acute pancreatitis patients retrospectively in a tertiary health care center.Methods: This study is a cross-sectional, retrospective hospital-based study that was conducted from Feb 2012 to Feb 2020 which was conducted on 500 patients who had acute pancreatitis in the department of general surgery and gastroenterology in a tertiary health care center.Results: Out of the total of 500 patients, 75% of males had acute pancreatitis and 25% of females had acute pancreatitis. The 52% of the patients had epigastric pain without radiating to the back and it was the most common clinical presentation followed by 30% of the patients had epigastric pain radiating to the back followed by generalized abdominal pain (18%). Nausea and vomiting were observed in most of the cases (71%). Alcohol-induced pancreatitis was the most common (41.2%) among the 500 cases, followed by idiopathic pancreatitis (36.2%). The acute fluid collection was identified in 26.6% of cases. The most prevalent systemic consequence was respiratory system involvement (15%).Conclusions: The most common clinical manifestation was epigastric pain with no radiation to the back. In our study, the incidence of alcoholic pancreatitis (41.2%) and idiopathic pancreatitis (36.2%) was slightly greater, prompting us to look for additional aetiologies in the idiopathic category in future investigations.