Background:Acute pancreatitis (AP) is characterized by a prolonged clinical course, pancreatic necrosis, multi-organ failure, and increased morbidity and death in thirty percent of patients who first present with abdominal pain.The aim of the present study was to compare the results of the urine trypsinogen-2 test with those of conventional tests (serum amylase & lipase) in the diagnosis of acute pancreatitis in the Emergency Department. Patients and methods: This comparative study was conducted in the emergency room at Suez Canal University Hospital. The study involved 52 patients divided into study group included 26 patients with acute pancreatitis, andcontrol group included 26 patients without acute pancreatitis. Results: In the present study 19 patients had mild AP (73%), 3 patients had moderate AP (11.6%) and 4 patients had severe AP (15.4%). Study group had significantly higher percentage of patients with bulky pancreas and GB stone. Serum amylase, lipase and Trypsinogen 2 were significantly higher among severe group than mild and moderate AP groups with statistical significant difference (p<0.05). Serum Trypsinogen 2 was significantly higher among study group than control group. Urine Trypsinogen 2 was significantly higher among study group than control group. The sensitivity of urinary trypsinogen 2 test in diagnosing AP was 100% and specificity was 92.3%.Positive predictive value was 92.9% and negative predictive value was 100%. Conclusion: Urinary trypsinogen-2 test is a promising fast and easy test performed in the effort of diagnosis of acute pancreatitis.