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Hyperthyroidism is one of the most common endocrinal disorders especially in females. Here, we described a 30-year-old female complaining of yellow discoloration of sclera, dark urine and pale stool. She had a history of controlled thyrotoxicosis under Methimazole one month before. tapering the Prednisolone dosage. She started treatment with Methimazole 20 mg daily, within one month she presented with acute cholestatic liver insult not otherwise attributed. Symptoms and laboratory findings were decreased on withdrawal, but not normalized. Her condition was controlled by beta blockers and subsequently Prednisolone.