The pancreatic acinar cell has been a classic model to study regulated exocytosis occurring at the apical plasma membrane. The acinar cell is also an excellent model with which to study pathologic membrane fusion events, including aberrant zymogen granule fusion with the lysosome and basolateral exocytosis, which are the earliest cellular events of acute pancreatitis. However, despite much effort, little is known about the precise mechanisms that mediate these physiologic and pathologic membrane fusion events until recently. Over the past 5 years, there has been a major advance in the fundamental understanding of vesicle fusion based on the SNARE hypothesis. A basic tenet of the SNARE hypothesis is that the minimal machinery for membrane fusion is a cognate set of v-and t-SNAREs on opposing membranes. A corollary to this hypothesis is that these SNARE proteins are prevented from spontaneous assembly by clamping proteins. Here, the recent developments in the identification of cognate v-and t-SNAREs and clamping proteins are reviewed, which are strategically located to mediate these physiologic exocytic and pathologic fusion events in the pancreatic acinar cell.