Fat accumulation within pancreatic acinar cells was observed by examination in patients consuming > 80 ethanol/day. Ultrastructural changes within the cell were described in these alcoholics without clinical pancreatitis which were similar to those seen in the hepatocytes of alcoholics. The mechanisms which induced these ultrastructural changes and accumulation of fat in the pancreatic acinar cell were not apparent. A toxic metabolic mechanism was a hypothesis for these effects.