Since its introduction >20 years ago, Azithromycin has been widely used owing to its broad spectrum and good tolerability, especially when used for <7 days. In literature, there are only very few, sporadic reports available of patients developing cholestatic hepatitis following treatment with it. The current case study describes a 69-year old patient, with a medical history that included significant alcohol consumption, who presented with jaundice following a 3-day course of Azithromycin. Following a transjugular liver biopsy, he was managed with a short course of corticosteroids and his liver function gradually improved and finally normalized ~2 months after discontinuation of Azithromycin.