Objective To observe the clinical efficacy of modified Chaihu Shugan powder in the adjuvant treatment of biliary acute pancreatitis. Methods A total of 40 cases of biliary acute pancreatitis were selected from June 2011 to October 2016 in the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine.The patients were randomly divided into treatment group and control group, with 20 cases in each group.Western medical treatment plans of both two groups were formulated according to the guidelines.The control group was given conventional western medicine.The treament group was given modified Chaihu Shugan powder on the basis of the control group.The abdominal pain symptoms, duration of aminotransferase descent and imaging findings before and after treatment were observed and compared. Results After treatment, the white blood cell count between the two groups had no statistically significant difference(t=0.28, P>0.05). The improvements of alanine aminotransferase, C-reactive protein and bilirubin in the treatment group were all better than those in the control group [(5.68±2.26)×109/L vs.(5.50±1.98)×109/L](t=-2.767, -2.96, -3.66, all P<0.05). Conclusion Modified Chaihu Shugan powder in the adjuvant treatment of biliary acute pancreatitis has significant effect, and it is safe. Key words: Pancreatitis; Bupleurum liver-coursing powder variation