The biliary pancreatitis should be treated with proper surgical approach in appropriate timing. For this, the early identification of gallstones and proper evaluation of severity are preceded. We reviewed the 78 cases of biliary pancreatitis which were treated at the Department of Surgery. Presbyterian Medical Center, Chonju, from Jan. 1984 to Dec. 1988 and reached conclusions as follows 1) The mean age was 512 years and the sex ratio was 1:1. 2) The incidence of biliary pancreatitis was 9.6% of cholelithiasis and 30.7% of acute pancreatitis. 19.2% of biliary pancreatitis was severe form (Glasgow criteria) and 20% of them were expired. 3) The early diagnosis (48 hours after admission) of gallstone was possible in only 51.3% of 78 by ultrasound, computed tomography and plain abdomen. 4) The proportions of cases in which the biochemical values on admission were alkaline phosphatase > 150 Iu/L, bilirubin > 1.6 mg/dl, SGOT > 100 Iu/L and SGPT > 50 Iu/L were much larger in biliary group than non-biliary. The cases in which three or more values of those were accepted by their criteria showed 80% of predictive value of gallstone and in this situation, 72% of diagnostic accuracy was predicted. 5) Gallbladder stones were found in 67.8% and 26.4% of them were severe pancreatitis. But the multiple CBD or IHD stones (32.1%) produced mild pancratitis mainly(96%). In mild pancreatitis the timing of surgery did not nearly affected the clinical course. But in severe cases, the conservative treatment resulted in high mortality (27.3%) and cholecystectomy + T-tube choledochostomy for urgent procedures and cholecystectomy + transduodenal sphincteroplasty for non-urgent procedures resulted in no mortality.