Background/Objectives: Acute pancreatitis (AP) is a common inflammatory disorder associated with substantial morbidity, mortality, and healthcare burden, particularly in patients with systemic inflammatory response syndrome (SIRS), pancreatic necrosis, and multiple organ dysfunction syndrome (MODS). Despite advances in intensive care management, nutritional support, and minimally invasive interventions, effective pharmacological therapies targeting the underlying inflammatory and enzymatic mechanisms remain limited. Protease activation, excessive inflammation, and immune dysregulation are key drivers of AP progression. Ulinastatin, a broad-spectrum serine protease inhibitor, exerts anti-inflammatory, antioxidant, and organ-protective effects by modulating protease activity, NF-κB signaling, cytokine production, and inflammasome activation. However, conventional intravenous administration is limited by rapid systemic clearance, nonspecific distribution, and insufficient drug exposure at sites of pancreatic inflammation, necessitating repeated dosing. This narrative review aims to evaluate the scientific rationale and the therapeutic potential of ulinastatin-loaded erythrocyte-based drug delivery systems as an innovative strategy for improving the efficacy of acute pancreatitis therapy by optimizing the sustained anti-inflammatory effect of ulinastatin in foci of pancreatic inflammation. Methods: Qualitative narrative synthesis of relevant experimental and clinical literature on AP pathogenesis, ulinastatin pharmacology and therapy, protease inhibition, erythrocyte ghosts, erythrocyte pharmacocytes, and erythrocyte-based drug delivery systems was critically reviewed. The analysis focused on evidence relevant to pancreatic inflammation, drug-delivery performance, potential therapeutic benefits, and translational limitations. Results: Available evidence supports the pharmacological relevance of ulinastatin in inflammatory and protease-mediated conditions and identifies erythrocyte-derived carriers as a potential platform for drug encapsulation, prolonged circulation, and controlled drug release. Direct experimental studies investigating ulinastatin-loaded erythrocyte pharmacocytes in AP are currently lacking. Conclusions: By combining the pharmacological properties of ulinastatin with the physiological advantages of erythrocyte-mediated drug delivery, this approach may offer potential therapeutic benefits. However, these potential advantages remain hypothetical and require validation through dedicated pharmaceutical characterization, pharmacokinetic, biodistribution, and efficacy studies. Ulinastatin-loaded erythrocyte pharmacocytes represent a scientifically plausible but currently unvalidated drug delivery strategy for AP. This narrative review critically examines the therapeutic rationale for combining ulinastatin with erythrocyte-derived drug carriers as a potential targeted delivery strategy for acute pancreatitis. It synthesizes relevant evidence on ulinastatin pharmacology, erythrocyte-based drug delivery, inflammatory mechanisms, and the limitations of conventional systemic administration. Particular attention is given to the potential advantages, translational challenges, and key research gaps associated with this proposed approach. Further preclinical studies are warranted to comprehensively evaluate their pharmacokinetic properties, biological activity, safety, therapeutic efficacy, and potential for clinical translation.