Background: Ketogenic diets (KDs) are high-fat, low-carbohydrate, and low-calorie diets that benefit weight control, metabolic disorders, and neurological disorders such as epilepsy. Hypertriglyceridemia (HTG) is an uncommon but well-established cause of acute pancreatitis (AP). This narrative review explores the link between KD and AP, focusing on the hyperlipidemic pathways involved. Aims: This review attempts to explore the potential effects and pathophysiology of a ketogenic diet on developing acute pancreatitis. Methods: Case studies and cohort studies were selected by searching PubMed, Cochrane Trials, and Google Scholar. A total of 12 articles were identified for inclusion in this review. Results: Individuals with KD, especially those with accompanying predisposing factors such as obesity, type 2 diabetes, and genetic predispositions, are at increased risk of developing HTG and subsequent AP. Further research is required to better understand the mechanisms linking KD to AP and to refine dietary recommendations for patients on this diet. Conclusion: A balanced approach, thorough monitoring, and personalized nutritional plans are essential to maximize the benefits of a KD while minimizing its adverse effects.