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Introduction -Acute pancreatitis takes the main place in the structure of surgical abdominal diseases. Endothelial dysfunction is one of the development mechanisms of the severe acute pancreatitis, which is accompanied by the formation of leucocytal and platelet microparticles, and massive cells apoptosis. Aim -To study lymphocytes apoptosis depending on severity of acute pancreatitis and area of pancreas and retroperitoneal cellular tissue affection. Material and Methods -We examined 40 patients with acute pancreatitis of IA phase of the disease, who were divided into two groups: with severe and non-severe course of the disease. Condition of lymphocytes plasma membrane in peripheral blood was estimated at admission of the patients by phase-contrast microscopy. Condition of pancreatic glandular tissue and retroperitoneal space were estimated by computed tomography angiography. Results -In most cases, non-severe acute pancreatitis was not associated with development of necrotic affection of pancreatic glandular tissue. In the event of severe acute pancreatitis structural changes of the pancreatic glandular tissue and retroperitoneal cellular tissue were in 95% of the cases. In cases of severe acute pancreatitis, the total blebbing of lymphocytes in terms of 100 cells was 33.5 (27.1, 39.7), terminal -21.9 (14.6, 28.3) (data presented as median with lower and upper quartiles). There were high positive correlations between the number of lymphocytes at terminal blebbing and affection in pancreatic gland tissue (r=0.76, p<0.001), also terminal blebbing and retroperitoneal space affection (r=0.82, p<0.001). Conclusion -Lymphocytes apoptosis in peripheral blood reflects the severity of acute pancreatitis.