Introduction: Hypertriglyceridemia (HTG)-induced acute pancreatitis (AP) during pregnancy is a rare but serious condition associated with high maternal and fetal complications. This condition is more common in multiparous women and typically occurs in the third trimester or early postpartum period, especially in the presence of risk factors such as pre-existing HTG and diabetes. Case Presentation: A 29-year-old primigravid woman presented at 21 weeks gestation to the obstetrics emergency department with acute, severe, persistent epigastric and left upper abdominal pain lasting for one day. Physical examination revealed tachycardia, slightly elevated blood pressure, and tenderness in the epigastrium and left upper quadrant. She had a history of primary infertility lasting three years but no other significant medical or surgical history. Her family history was negative for any specific diseases. Laboratory examinations showed elevated serum amylase levels (1170 IU/L) and a markedly high serum triglyceride level (8100 mg/dL). A diagnosis of acute HTG-induced pancreatitis was made, and the patient was successfully treated with a combination of plasma exchange, low molecular weight heparin, and an insulin/potassium/dextrose infusion. Pregnancy was completed with an elective cesarean delivery at 38 weeks gestation, with no episodes of recurrence or related complications observed during the follow-up period. Conclusions: Acute pancreatitis should be considered as a differential diagnosis in pregnant women presenting with epigastric pain across all trimesters, even in patients with no family or personal history of HTG, as early diagnosis can significantly improve maternal outcomes.