Background: The accumulation of fat in the pancreas has greater clinical significance. It is unclear, though, how much the intermediate variables influence the fat deposition in these depots. This study aimed to determine the relation of pancreatic steatosis to Diabetes Mellitus, Acute Pancreatitis and Pancreatic Cancer. Subjects and Methods: This case-control study was conducted on fifty patients for pancreatic diseases in internal medicine department at Zagazig University Hospitals, equally divided into five groups; group I: 10 cases as a control group, group II: with fatty pancreas, group III: with acute pancreatitis (AP), group IV: with Diabetes Mellitus and case group V: with pancreatic cancer (PC). Patients were subjected to full medical history, physical examination, laboratory investigations, non-contrast CT. Results: Age and males were significant increased in group V. BMI and females were higher among fatty pancreas patients. Pancreatic steatosis diagnosed by CT in FP representing 100%, in acute pancreatitis 60%, DM 80% and PC 70% of patients, and it was worse in FP group as 40% ware grade 4. Fatty liver diagnosed by CT in 100% of FP patients, 70% in AP and DM groups and 60% in PC group, and was worse in FP group as 80% grade 3. grades of fatty liver and LDL cholesterol significantly independently associated with fatty pancreas. High lipids, diabetes and grades of fatty liver were significantly associated with fatty pancreas and LDL and fatty liver are independent risk factors. Conclusion: Pancreatic steatosis is highly related to Diabetes Mellitus, Acute Pancreatitis and Pancreatic Cancer.