Abstract: Acute pancreatitis (AP) is an inflammatory disease of the pancreas, characterized by the activation of various inflammatory factors, followed by local inflammation of pancreas, and some serious patients can occur in systemic inflammatory response syndrome (SIRS). As one of the most common acute and severe diseases in digestive system diseases, AP has been received much attention because of its rapid onset, severe illness, easily complicated with multiple organ dysfunction, and there is an increasing trend in the incidence, causes higher mortality in critically ill patients. However the etiology and pathogenesis of AP has not yet been fully clarified. The traditional view is that there is a close correlation between the pancreas self digestion, the body's excessive inflammatory response, systemic microcirculation disturbance and intestinal flora translocation and the occurrence and development of acute pancreatitis. In recent years, it has gradually become one of the hottest spots to explore its pathogenesis from the point of view of microcirculation disturbance. The changes of microvascular structure and function, blood rheology and release of vasoactive mediators play an important role in the occurrence and development of microcirculatory disturbance in acute pancreatitis. Various factors separately and jointly promote the initiation and progression of the disease. Although acute pancreatitis originated in the pancreas, it can cause multiple organ damage, and the disturbance of microcirculation is the important cause of the injury of the pancreas and the external organs. In this review, the advances of mechanism of microcirculation disturbance in acute pancreatitis and the related microcirculation disturbance of main organs are reviewed in order to provide a basic understanding for the majority of scholars on the microcirculation disturbance in acute pancreatitis related research, then seek the exact mechanism of microcirculation disturbance in acute pancreatitis, to bring the gospel to many of the patients with acute pancreatitis.