Most cases of acute pancreatitis are routinely managed in the hospital without complications. However, management could become very complicated when patients present with a combination of acute pancreatitis and diabetic ketoacidosis (DKA). In fact, triad of acute pancreatitis, DKA, and hypertriglyceridemia in patients could result into systemic complications which may lead to fatal consequences. We report 2 cases in which patients presented with acute pancreatitis and DKA. Clinical course was complicated for both cases. While one of the patients expired, the other patient could not be extubated. This combination must be avoided at all costs because the clinical outcome for affected patients is difficult to predict.