Objective To assess the efficacy and safety of fat emulsion (FE) for acute pancreatitis (AP).Methods We searched the electronic biological databases: Cochrane Controlled Trials Register (Issue 2, 2007), Medline(1996 to April 2007), EMBASE (1984 to April 2007), Chinese biological medical database (1978 to April 2007). We alsodid handsearching to identify other published and unpublished data. Data collection and undertaken by two reviewersaccording to the Cochrane Handbook for Reviews of Intervention. Randomized controlled trials (RCTs) or quasi-RCTscomparing FE versus glucose in the treatment of AP were collected. Pooled estimates of overall treatment effect werecalculated using the RevMan 4.2.10 according to available data from included studies. Otherwise, qualitative descriptiveanalysis was performed. Results In total, 10 clinic control trials finally (include 314 participant) met the eligible criteria. ① To long chain triglyceride (LCT), the comparison of overall mortality (relative risk, 0.73; 95%CI, 0.34 to 1.58; P=0.26) and complications (Pgt;0.05) showed no significant difference. One study reported LCT cannot reduce hospital stay (Pgt;0.1). The effects of LCT on cholesterol and triglyceride were inconsistent with respect to the course of treatment. ② However, there were no changes of the cholesterol and triglyceride levels secondary to the medium chain triglyceride and long chain triglyceride (MCT/LCT) (Pgt;0.05, respectively) according to one study. ③ No severe adverse events were reported.Conclusions The evidence currently available cannot conclude that FE is safe and effective, though LCT may decreasethe mortality of AP. Therefore, more high-quality trails are needed.