There are readily accessible inflammatory markers that could help with timely and effective management and risk stratification.<h4>Purpose</h4>The purpose of the study is to determine the predictive value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein (CRP) in determining the severity of acute pancreatitis (AP).<h4>Methods</h4>This retrospective multicenter cohort study included 272 adult patients admitted to two tertiary care hospitals in Pakistan (Lahore, n=142; Islamabad, n=130) with confirmed AP between September 2025 and December 2025. Here, CRP is linked to alkaline phosphatase measurement.