Objective: To compare the value of procalcitonin (PCT) and c-reactive protein (CRP) in early diagnosis and treatment of acute biliary pancreatitis. Methods: Data from a total of 195 patients diagnosed with acute pancreatitis (AP) from January 2014 to March 2018 in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine were retrospectively analyzed. According to the etiology, the patients were divided into acute biliary pancreatitis (ABP) and acute non-biliary pancreatitis (ANBP) groups. And the ABP group was further divided into mild ABP (MABP), moderately severe ABP (MSABP) and severe ABP (SABP) groups according to the severity of the disease. Differences of PCT and CRP levels within 48 hours after admission and the in-hospital death rate were compared between these groups. Results: In the early 48 hours after admission the level of PCT in patients with ABP was higher than that of ANBP（P<0.05), while there was no difference in CPR between 2 groups. Serum procalcitonin level within 48 hours after admission in SABP group was significantly higher than those in MABP and MSABP groups. Procalcitonin level within 48 hours after admission was significantly higher in the dead group than in the surviving group (P<0.001), and CRP levels within 48 hours after admission had little differences among these groups（P=0.769）. Conclusions: In the early 48 hours after admission, the detection of serum PCT level is superior to CRP level for evaluating the severity and prognosis of ABP.