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BACKGROUND Acute pancreatitis (AP) is a common disease of the digestive system. The mechanism of hyperbaric oxygen (HBO) therapy for AP is not completely clear. AIMS This study investigated the effects of HBO in AP and whether it acts through the mitochondria-mediated apoptosis pathway. METHODS Eighty male Sprague-Dawley rats were randomly assigned to four groups control (8 rats), sham (24 rats), AP (24 rats), or AP + HBO (24 rats). AP was induced by ligating the pancreatic duct. The AP + HBO group was given HBO therapy starting at 6 h po