Background: ACS (abdominal compartment syndrome) is a serious condition that affects critically ill people. Because it predominantly affects individuals who are already sick, it may go unnoticed. The aim of study to find a link between IAP and the development of problems in patients with severe acute pancreatitis. We also wanted to see if there was a link between IAP and the development of complications in patients with severe acute pancreatitis (SAP). Patients and methods: This prospective study was conducted on 18 patients with AP hospitalised to the Surgical Intensive Care Unit at Zagazig University's Faculty of Medicine's General Surgery Department (SICU). During the first week after admission, all patients were divided into two groups based on their IAP. Patients with IAP 20 mmHg were assigned to the IAH group, whereas those with IAP 20mmHg were assigned to the normal IAP group. Results: Age, serum Lipase and APACHE were significantly higher among ACS cases and also ACS cases were significantly associated with DM. ACS cases were significantly associated with longer hospital stay also with bleeding, septic shock and mortality.The mean Lipase level was 959.72±103.58 with rang (800-1200). The mean Intra-abdominal pressure of studied patients was 12.94±4.12 and 38.9% of patients had IAH while 2 cases 11.1% had ACS. Conclusion: In patients hospitalised to the ICU with severe acute pancreatitis, IAH and ACS are common findings. IAH could make severe acute pancreatitis worse. Early detection of this possibly treatable aggravating condition could lead to early management and, in turn, a better prognosis.