Ascaris Lumbricoides was the most common helminth in Korea, but the prevalence of ascariais has decreased to 0.05%, so as the incidence of biliary ascariasis. The incidence of pancreatitis due to biliary ascariasis is relatively common in endemic areas, but in Korea only one case has been reported since 1985. A 71-year-old man was admitted with a sudden onset of nausea, vomiting and severe epigastric pain. He was diagnosed as acute pancreatitis based on physical findings and an elevated serum amylase level. Magnetic resonance cholangiopancreatography (MRCP) that was performed on admission revealed diffusely enlarged pancreas with fluid collection and long tubular structure in the common bile duct, which showed intermidiate signal intensity on T1 weighted image and low signal intensity on T2 weighted image. Also, endoscopic retrograde cholangiopancreatography (ERCP) was performed to treat biliary ascariasis. After sphincterotomy, ascaris was extracted by a basket without any complication.