〔Abstract〕 To analyze the temporal changes in lipid levels in patients following acute pancreatitis(AP) and explore the factors associated with post-AP serum triglyceride(TG) level changes. Methods Patients diagnosed with AP at a Hospital in Yangzhou between January 2017 and December 2020 were included in this study. Clinical data were collected retrospectively, and lipid profile data from follow-up visits after discharge were tracked. The follow-up period extended until January 1, 2024. Kaplan-Meier(K-M) curves were used to stratify follow-up duration, while Spearman correlation analysis assessed the relationship between lipid levels and follow- up time. A linear regression model was used to investigate factors influencing TG level changes post-AP. Results A total of 141 patients with 306 follow-up visits were included. Spearman correlation analysis showed a mild increase in lipid levels over time post-discharge: TG(r=0.159, P=0.005), total cholesterol(TC)(r=0.231, P＜0.000 1), High-Density Lipoprotein Cholesterol(HDL-C)(r=0.181, P=0.002), and ApolipoproteinA1(ApoA1)(r=0.371, P < 0.000 1). In the univariate linear mixed model,male gender(β=0.160,P=0.007), Body Mass Index(BMI) (β=0.017, P=0.007), diabetes history(β=0.138, P=0.030), smoking history(β=0.166,P=0.004),and recurrent AP(β=0.119, P=0.029) were significantly associated with Lg(TG) levels (P<0.05). In the multivariate model, BMI(β=0.019, P=0.042), smoking history(β=0.155, P=0.049), and recurrent AP(β=0.148,P=0.032) remained significantly positively correlated with changes in Lg(TG) levels after AP, albeit with a low correlation strength (r < 0.200). Conclusion Lipid levels, including TG, TC, HDL-Cand ApoA1, tend to increase over time in AP patients after discharge, with this trend being more pronounced in those with hypertriglyceridemic acute pancreatitis. Post-AP TG levels are significantly influenced by BMI at the time of onset, smoking history and recurrent AP.