Acute pancreatitis (AP) is an acute surgical disease of the abdominal cavity that becomes severe in 20-30% of patients and has a mortality rate reaching 25%. Hypoxia that occurs during AP may be associated with the activation of a regulatory protein, hypoxia-inducible factor-1á (HIF-1á), which plays an important role in the body’s response to hypoxia. The HIF-1 transcription factor induces the expression of genes involved in cell proliferation, angiogenesis, neurogenesis, erythropoiesis and cellular metabolism, and maintenance of intracellular pH. The purpose of the work is to study the relationship between HIF-1á blood levels and polymorphism of the HIF-1A gene with the criteria of hypoxia, tissue damage and severity of AP. We examined 93 patients with AP of varying severity on days 1 and 3 of the disease, age 48 (39-67) years. We identified 3 groups of patients: with mild AP – 32 people, moderate – 26 people, or severe – 35 people. The comparison group consisted of 25 healthy volunteers, average age 47 (39-56) years. The HIF-1á levels, the presence of HIF-1A gene polymorphism, interleukin-6, C-reactive protein, procalcitonin, ferritin, D-dimer, S100 protein, clinical blood test, and blood gas composition were assessed. In patients with AP, clinical and laboratory signs of acute inflammation, microcirculation disorders, hypoxia and organ dysfunction were observed. With mild severity of AP on days 1-3 of observation, the HIF-1á level exceeded its content in the comparison group. With moderate and severe AP, the production of HIF-1á as a factor of adaptation to hypoxia decreased. A relationship was found between the HIF-1á level and the severity of AP. In the same patients, the HIF-1A gene polymorphism (1772CT, rs11549465) was studied to identify carriage of the C/C, C/T and T/T genotypes. It was determined that among the patients, patients with С/С predominated, in whom the concentration of HIF-1á was lower than in the group with С/T. Mortality among patients with the C/C genotype and severe AP was 47%. In the group with the C/T genotype, all patients were discharged, including those with severe AP. A relationship was found between HIF-1á blood levels and the marker of tissue damage S100, mixed hypoxia – lactate, and acid-base state – pHt. The results allow us to consider HIF-1A genotypes as potential predictors of the severity of AP.