Objective   To investigate the correlation between the visceral adipose tissue area (VFA) and the clinical efficacy of double filtered plasma exchange (DFPP) in patients with hyperlipidemic pancreatitis (HLAP).  Methods   A total of 225 patients with HLAP treated with DFPP in First People's Hospital of Zigong City from January 2020 to December 2022 were selected and divided into effective group (n=180) and ineffective group (n=45) according to the clinical efficacy. General clinical data and VFA were compared between the two groups. Multivariate logistic regression was used to analyze the influencing factors for the ineffective outcomes. The dose-response relating to VFA level and the probability of ineffective treatment was analyzed. Based on the influencing factors, a prediction model was established and verified.  Results  Drinking history (OR=3.603, 95% CI: 2.577～4.868, P=0.018), high BMI (OR=2.407, 95% CI: 1.381～3.672, P=0.016), high APACHE Ⅱ score (OR=3.087, 95% CI:2.061～4.352,P=0.026), high fasting plasma glucose (FPG) (OR=1.313, 95% CI: 1.007～2.578, P=0.009), high total cholesterol (TC) (OR=2.511, 95% CI: 1.485～3.776, P=0.025), high triglycerides (TG) (OR=4.885, 95% CI: 3.859～6.150, P=0.035), high LDL-C (OR=3.165, 95% CI: 2.139～4.430, P=0.010), low HDL-C (OR=4.163, 95% CI: 3.137～5.428, P=0.011), high IL-6 (OR=2.117, 95% CI: 1.091～3.382, P=0.006), high IL-8 (OR=3.115, 95% CI: 2.089～4.380, P=0.023), high C-reactive protein (CRP) (OR=1.975, 95% CI: 1.049～3.240, P=0.035), high procalcitonin (PCT) (OR=3.665, 95% CI: 2.639～4.930, P=0.036), high blood amylase (OR=4.547, 95% CI: 3.521～5.812, P=0.041), high blood lipase (OR=2.229, 95% CI: 1.203～3.494, P=0.043), and large VFA (OR=2.827, 95% CI: 1.801～4.092, P=0.031) were the influential factors for efficacy. Dose-response relationship analysis showed that with the increase of VFA, the probability of clinical ineffective treatment increased as well. The regression equation was P=1/[1+exp(-3.265+1.282×drinking history+0.878×BMI+1.127×APACHE Ⅱ score +0.272×FPG+0.921×TC+1.586×TG+1.152×LDL-C+1.426×HDL-C+0.750×IL-6+1.136×IL-8+0.681×CRP+1.299×PCT+1.514×blood amylase+0.802×blood lipase+1.039×VFA)].   Conclusion  In HLAP patients, VFA is significantly correlated with the clinical efficacy of DFPP, and the probability of clinical non-efficacy is gradually increased along with the increase of VFA.