Objective: To investigate the pancreatitis characterized by pancreatitis (AP) treated with microwave therapy combined with ulinastatin. Methods: 83 AP patients treated in the gastroenterology department of our hospital from February 2022 to May 2024 were selected as the study objects. The patients were divided into control group (41 cases) and observation group (42 cases) by random number table method. Both groups received conventional basic treatment. On this basis, the two groups received different treatment methods. The control group was treated with ulinastatin. The observation group was treated with microwave physiotherapy combined with ulinastatin. The improvement of clinical symptoms, the inflammatory indexes [Procalcitonin (PCT), C-reactive protein (CRP)] and intestinal barrier function [serum Diamine oxidase (DAO), D-Lactate (D-LA)] and the occurrence of adverse reactions of the two groups was analyzed and compared. Results: The time of abdominal pain relief and gastrointestinal function recovery in the observation group were significantly shorter than those in the control group (P < 0.05). After 7 days of treatment, serum PCT and CRP in both groups were significantly decreased compared with before treatment, and serum PCT and CRP in observation group were significantly decreased compared with control group (P < 0.05). After 7 days of treatment, serum DAO and D-LA levels in both groups were significantly lower than before treatment, and serum DAO and D-LA levels in the observation group were significantly lower than those in the control group (P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P > 0.05). Conclusion: Microwave therapy combined with ulinastatin therapy can promote the improvement of clinical symptoms, reduce inflammatory response and improve intestinal barrier function in patients with AP, with good safety.