Hypertriglyceridemia is a complication of many medical conditions like diabetes and alcoholism. Extremely high triglyceride levels are known to cause pancreatitis. Aggressive lipid lowering by drugs and/or apheresis is the mainstay of therapy. We here report a case of alcoholic and diabetic male with triglyceride level of more than 4000 mg/dl. He presented with acute pancreatitis and multi organ dysfunction and could not be salvaged. This case highlights the need of measuring lipid levels in critical care. This is probably the first report of such extreme triglyceride levels from India.