Background: The etiology and pathogenesis of hyperlipidemic pancreatitis are not yet fully understood, and the relationship between the severity and different causes of this disease is still not clear. Now the treatment of hyperlipidemic pancreatitis is mainly to reduce the elevated serum triglyceride and control the secondary risk factors. For severe hyperlipidemic pancreatitis, which can deteriorate in a very fast speed, more efficient and effective therapeutic methods are needed. Case presentation: The patient was a 32-year-old Chinese woman in her 32-week gestation. She was previously healthy, and came to have a sudden onset of acute pancreatitis induced by hyperlipidemia. Her situation deteriorated rapidly, and she simultaneously developed fetal death, respiratory failure, acute renal injury, and severe infections in the lungs, abdominal cavity and the wound. Besides traditional therapies, we used plasmapheresis treatment and successfully saved her life. Conclusion: In recent years, hyperlipidemic pancreatitis and hyperlipidemic pancreatitis during pregnancy seem to happen more frequently than before. For the extremely severe hyperlipidemic pancreatitis, plasmapheresis seems to be a safe and efficient therapeutic approach, and is often needed to save the patients’ lives. However, evidence for evaluating the efficiency and safety of plasmapheresis in the treatment of hyperlipidemic pancreatitis is still scarce, and we think high-quality, large-scale RCTs in this field are needed for further studies. In addition, by reporting this case, we want to remind general readers to pay attention to adopting a healthy lifestyle, and to encourage researchers and healthcare professionals to continue this research.