Acute pancreatitis is uncommon in children and adolescents, and when it does occur, it is rarely fatal. The cause of death may be misdiagnosed as a death due to diabetic ketoacidosis or an infectious disease if an autopsy is not performed. Because these deaths are often unexpected and may occur before medical care, the forensic pathologist may be contacted to determine the cause of death. Even deaths that occur after hospitalization may be referred to the medical examiner because of the concern for drug involvement, the unusual age of the decedent, or the decreased availability for a hospital autopsy. We report a fatal case of acute pancreatitis in a 14-year-old adolescent girl who was brought unresponsive to the emergency room of a university hospital and died after unsuccessful resuscitation efforts.