Acute pancreatitis due to hypertriglyceridemia during pregnancy is a rare condition that can be associated with significant complications for both mother and fetus. We report two cases of hypertriglyceridemic pancreatitis in pregnancy and highlight the early decision of emergency cesarean section and postpartum maternal care. A 37-year-old primigravida woman with 35 weeks 5 days of gestation came to emergency room, presented epigastric pain and nausea, vomiting. Serum amylase and lipase and cholesterol, triglyceride were raised. Abdomen ultrasound showed buldging contour of pancreas with peripancreatic fluid suggestive of pancreatitis and MRI cholangiogram showed no pancreatic duct dilatation, no visualization of pancreatolithiasis. With the impression of necrotizing acute pancreatitis, patient was managed conservatively, however, emergency cesarean delivery was decided in consideration of uncontrollable epigastric pain and non-reassuring fetal heart rate. A 32 years old gravida 2 para 1 woman with 32 weeks of gestation presented severe epigastric pain and nausea, vomiting. She had a past history of acute pancreatitis with pure hypertriglyceridemia one year ago and treated with fenofibrate. Serum amylase and lipase, CRP were elevated. Cardiotocography showed irregular uterine contraction of waveform and fetal heart rate baseline was elevated up to 170. In the context of uncertain fetal status, emergency cesarean section was decided. Early diagnosis and prompt decision of cesarean delivery leads to good perinatal outcome.