Background: Coexisting medical complications in pregnancy can present in a fashion similar to preeclampsia and can be challenging to differentiate., Case: We present a patient who, at 27 3/7 weeks of gestation, fulfilled diagnostic criteria for severe preeclampsia, including hypertension, proteinuria, headache, abnormal serum creatinine levels, thrombocytopenia, and liver function abnormalities, but who nevertheless did not have preeclampsia. Instead, she was diagnosed with alcoholic pancreatitis based on a history of heavy alcohol use and elevated amylase and lipase. Abnormal laboratory values resolved with supportive therapy, and she continued to term without subsequent recurrence of proteinuria or hypertension., Conclusion: Alcoholic pancreatitis can be mistaken for preeclampsia.