A 50-year-old man with a 30-year history of alcohol abuse was admitted because of abdominal pain. Based on an elevated serum amylase level and abdominal computed tomography findings, a diagnosis of alcoholic pancreatitis was made. The pancreatitis improved after 1 month of conservative therapy, but the patient complained of a tender right ankle that showed no abnormal findings on X-ray examination. Two months later, the patient was readmitted for recurrent pancreatitis and a swollen, warm, tender right ankle. Imaging studies, including plain radiographs, magnetic resonance imaging, and a bone scintigram showed the typical findings of intraosseous fat necrosis of the right tibia. We report a rare case of intraosseous fat necrosis associated with alcoholic pancreatitis.