ObjectiveTo compare the predictive value of Balthazar computed tomography severity index (CTSI), Modified computed tomography severity index (MCTSI) and extrapancreatic inflammation on CT (EPIC) in patients diagnosed as acute pancreatitis with organ dysfunction based on the revised Atlanta classification. MethodsThe clinical data of patients diagnosed as acute pancreatitis from December 2013 to January 2014 were analyzed retrospectively. Four imaging score systems (CTSI, MCTSI, EPIC, and local complications) and two clinical score systems were assessed with ROC and AUC. Results①There were no statistical significances in the age, gender, time after onset of symptoms to CT scanning in 54 patients (P > 0.05).②CTSI, MCTSI, EPIC, and local complications were good independent predictors of organ dysfunction in the early phase (P < 0.05), while BISAP and NJSS were not (P > 0.05). ConclusionCT scoring systems can accurately evaluate organ dysfunction of acute pancreatitis in the early phase.