Objective To evaluate the effect of double filtration plasmapheresis (DFPP) on patients with hyperlipidemic acute pancreatitis (HL-AP). Methods The clinical data of the patients with hyperlipidemic severe acute pancreatitis (HL-SAP) or moderately severe acute pancreatitis (HL-MSAP) from January 2019 to May 2022 were collected. The patients were divided into two groups,the control group received conventional treatment, DFPP group received DFPP treatment on the basis of conventional treatment. Results Compared with the control group, the following parameters changed significantly in DFPP group, triglyceride (TG), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) decreased on day 1 and 2, estimated glomerular filtration rate (eGFR) increased on day 1, 2, 3 and 5, leukocyte and neutrophil counts decreased on day 1 and 2, hemoglobin (HGB) decreased on day 1, 2, and 3, C-reactive protein (CRP) decreased on day 1, 2, 3, 5, and 7. And the patients in DFPP group receiving mechanical ventilation decreased compared with that in control group. Conclusion Compared with conventional treatment, DFPP can reduce plasma TG faster, improve lung, liver and kidney function, reduce inflammatory markers, and facilitate early fluid recovery.