Abstract: Pancreas transplantation and simultaneous pancreas-kidney transplantation are the most effective treatments for diabetes, end-stage diabetic nephropathy, or diabetes combined with end-stage renal disease, which have achieved good therapeutic effects in the treatment of type 1 diabetes and some cases of type 2 diabetes. However, acute rejection of transplant pancreas remains one of the important factors affecting the survival of recipients and the transplant pancreas after pancreatic transplantation, and it is a key issue that needs to be urgently addressed. In order to further standardize the clinical diagnosis and treatment of acute rejection of transplant pancreas, experts in organ transplantation, transplantation pathology and immunology from the Branch of Organ Transplantation of Chinese Medical Association organized a joint effort to formulate the "Clinical diagnosis and treatment guidelines for acute rejection of transplant pancreas". The content covers 14 key clinical issues such as acute T-cell mediated rejection of transplant pancreas, acute antibody-mediated rejection, transplant pancreas biopsy, pathological standards, diagnosis and treatment methods. It summarizes 17 evidence-based recommendations. The guideline was developed based on the evidence grading and recommendation strength standards of the Oxford University Evidence-Based Medicine Center's 2009 edition, aiming to guide clinical practice through evidence-based methods, with the goal of improving the diagnosis and treatment level of acute rejection of transplant pancreas in China.