Objective To explore the inflammatory status and multi-slice spiral CT (MSCT) performance in patients with acute pancreatitis (AP) of different severity. Methods The clinical data of 68 patients with AP admitted to our hospital from May 2016 to May 2018 were analyzed retrospectively. According to the severity of AP, the patients were divided into mild acute pancreatitis group (MAP group, 41 cases) and severe acute pancreatitis group (SAP group, 27 cases). And another 20 healthy examiners at the same time were selected as control group. All the three groups were given MSCT examination, and the CT classification was recorded. The levels of serum C-reactive protein (CRP), serum amylase (AMY) and urinary amylase (UAMY) were compared among the three groups. Results The serum CRP level in MAP group and SAP group was higher than that in control group, and the level in SAP group was higher than that in MAP group (P<0.05). The levels of AMY and UAMY in MAP group and SAP group were higher than those in control group (P<0.05), and there was no statistically differences (P>0.05). The cases of grades A, B, C, D and E of Balthazar CT score were 8, 15, 20, 20 and 5. Conclusion The inflammatory status of SAP patients is significantly worse than that of MAP patients. There are also significant differences in CT performance, which can be used as important basis for disease assessment.