Vascular thrombosis and systemic hypercoagulable states are known complications of pancreatitis. Higher levels of mean platelet volume (MPV) have been associated with thrombotic diseases. However, a few studies have investigated the association between acute pancreatitis and MPV. We aimed to investigate whether there is a difference of MPV and coagulation parameters in patients with active and remission in acute pancreatitis. We included 24 consecutive patients with biliary acute pancreatitis and 24 consecutive healthy age-matched and sex-matched controls. Full blood counts and other laboratory tests were collected at onset and remission. The MPV was significantly higher in patients with acute pancreatitis at admission 8.6 +/- 1.4 fl than controls 7.6 +/- 0.7 fl (P=0.005). We detected positive correlation between, aspartate aminotransferase, alanine aminotransferase, g-glutamyltransferase, amylase, lipase, and glucose, BMI, D-dimer and MPV. However, there was negative correlation between progression, thrombocyte counts, hemoglobin and MPV. As a result higher MPV levels in acute pancreatitis may reflect hypercoagulation associated with pancreatitis. Blood Coagul Fibrinolysis 24:243-246 (C) 2013 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.