Objective To investigate the relationship between the number of attacks of hypertriglyceridemic acute pancreatitis (HTG-AP) and the severity of the disease. Methods A total of 305 patients with HTG-AP from the Affiliated Hospital of Yangzhou University were enrolled. Patients were categorized into the first attack group, the first relapse group, and the multiple relapse group based on the number of acute pancreatitis attacks, and the severity of the disease among the groups was compared. Results Among the 305 patients with HTG-AP, 217 (71.15%) experienced their first attack, 56 (18.36%) had their first relapse, and 32 (10.49%) had multiple relapses. The proportion of patients with moderately severe or severe acute pancreatitis in the first attack group was 25.81% (56/217), which was higher than that in the first relapse group (12.50% ［7/56］), but significantly lower than that (43.75%［14/32］) observed in the multiple relapse group. Additionally, there were significant differences in bedside index for severity in acute pancreatitis (BISAP) and computed tomography severity index (CTSI) scores among the 3 groups (P＜0.05), with the multiple relapse group showing significantly higher scores than the other 2 groups. Conclusion The number of relapses in patients with HTG-AP is closely associated with the severity of the disease; the more relapses, the more severe the condition.