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Context Propofol can cause acute pancreatitis related to hypertriglyceridemia, however, other mechanisms may also exist. Case report A 71-year-old male on propofol infusion in the intensive care setting, developed acute pancreatitis as confirmedbiochemically and by imaging. He did not have any elevation of triglycerides and on propofol re-challenge, had recurrence of pancreatitis with the absence of triglyceride elevation. Conclusion We report a case of hypertriglyceridemia independent propofol induced pancreatitis possibly related to an idiosyncratic reaction and propose that this drug to be reassigned as a class Ia drug as an etiologic factor for acute pancreatitis.