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INTRODUCTION: We aimed to compare the severity of the disease with derived neutrophil to lymphocyte ratio (DNLR) and monocyte to high-density lipoprotein ratio (MHR) in patients with acute pancreatitis (AP). METHODS: This retrospective study included 52 patients with Ranson 0, 57 patients with Ranson I, 39 patients with Ranson II, 36 patients with Ranson III–IV, and 20 healthy controls as the control group with similar demographic characteristics to the patient groups. Demographic characteristics, mortality, etiology, and laboratory data of the patients were evaluated from their previous records. RESULTS: The study data were compared in five groups as control and Ranson 0, I, II, III–IV according to their AP stage. MHR values were 9.62+-4.25 in the control group and 13.4+-5.18, 14.2+-4.22, 19.4+-10.5, 31.7+-26.3 in Ranson 0, I, II, III–IV, respectively (p<0.001). DNLR was 1.33+-0.45 in the control group and 3.48+-2.68, 3.71+-2.31, 4.43+-2.84, 4.62+-3.46 in Ranson 0, I, II, III–IV, respectively (p<0.001). MHR and DNLR values were significantly different in patients with AP. DISCUSSION AND CONCLUSION: The levels of MHR and DNLR evaluated during the follow-up of patients with AP are low-cost and easy to access parameters that may help the clinician in determining the severity of the disease.