Abstract: Objective: To observe the effect of ulinastatin combined with octreotide and analysis of treatment of severe acute pancreatitis patients with serum endotoxin and intestinal permeability. Methods: 88 patients with severe acute pancreatitis were randomly selected from January 2015 ~2016 year in June in our hospital, were randomly divided into observation group (n=44) and control group (n=44), the control group were treated with octreotide treatment, observation group were treated with octreotide combined with ulinastatin treatment, observation of serum levels of endotoxin, hs-CRP, intestinal mucosal permeability before and after treatment in two groups. Results: before treatment, two groups of patients with hs-CRP, endotoxin, plasma DAO concentration and L/M ratio compared no significant difference, no statistical significance (P>0.05); after treatment, two groups of patients the levels of endotoxin and hs-CRP were significantly lower than those before treatment (P<0.05), the two groups of patients with plasma DAO concentration was significantly lower than that before treatment (P<0.05), the ratio of L/M was significantly higher than that before treatment (P<0.05); and the patients in the observation group the levels of endotoxin, hs-CRP and plasma DAO concentration was significantly lower than the control group (P<0.05), L/M ratio was significantly lower than the control group (P<0.05). Conclusion:The use of octreotide combined with ulinastatin in the treatment of patients with severe acute pancreatitis, can significantly decrease the serum endotoxin level of patients, and can help restore intestinal mucosal barrier function in patients. Key words: Severe acute pancreatitis; octreotide; Ulinastatin; endotoxin; intestinal permeability