A case presentation of a pregnant female with right upper quadrant abdominal pain is presented, and the learner is guided through identifying, diagnosing, and treating a case of gallstone pancreatitis. Differential diagnoses of abdominal pain in a pregnant female are discussed, as well as the physiologic changes during pregnancy that contribute to the increased risk of gallstone formation. Increased levels of reproductive hormones during pregnancy induce a variety of physiologic changes in the biliary system, which promote gallstone formation. Management of gallstone pancreatitis, as well as the timing of cholecystectomy, typically in the same index hospitalization, is discussed.