1) serum MIF levels were raised in severe AP (median 58, range [13–181] ng/ml), multiple organ failure, or pancreatic necrosis compared with mild AP (20 [5–80] ng/ml) or healthy controls (18 [12–57] ng/ml) (all p < 0.01); 2) serum MIF levels significantly correlated with serum 24-h CRP (r = 0.36, p = 0.02), peak CRP (r = 0.36, p = 0.003), and 48-h APACHE II score (r = 0.29, p = 0.03). 3) 24-h serum MIF was superior to sCD14 and sCD163 in predicting severity (AUC, 0.84), multiple organ failure (AUC, 0.80), and pancreatic necrosis (AUC, 0.86) (all p < 0.001). Here, CD163 is linked to Multiple Organ Failure.