Background: Acute pancreatitis is a rare but recognised complication of clozapine leading to termination of treatment.
Case Presentation: We present the case of a 39-year-old man with treatment-resistant schizoaffective disorder and a history of recurrent acute pancreatitis attributed to clozapine. After 15 years of unremitting symptoms with disruptive and aggressive behaviour, he was admitted for a clozapine rechallenge.