Acute cellular rejection (ACR) is still an important problem affecting patients after liver transplantation. Early diagnosis is necessary for initiate treatment, but there are not simple, noninvasive methods to confirm the diagnosis, and up to now, the gold standard in the evaluation of ACR is liver biopsy. The blood eosinophilia seems to be a promising tool supporting the diagnosis and monitoring the effectiveness of ACR treatment in patients after liver transplantation. In this paper a young patient transplanted due to primary sclerosing cholagitis with blood and graft eosinophilia is presented. Based on this interesting case, the literature overview is presented. We conclude that blood eosinophilia, especially with concomitant increase of gamma-glutamyl transpeptidase activity and bilirubin concentration could be an effective tool to predict ACR and may help to choose the.