CASE PRESENTATION: A 47 year old male with past medical history significant for recurrent pancreatitis and pseudocyst,hypertension,diabetes mellitus and pulmonary sarcoidosis presented to our hospital with vague complaints of nausea,vomiting,abdominal pain and yellowish discoloration of his eyes.Workup showed elevated liver enzymes with a total bilirubin of 9. His CT scan showed fatty liver with no abnormality of the hepatobiliary tree.He subsequently had an ERCP performed that showed a biliary stricture for which he had a stent placed. His bilirubin continued to increase after the procedure to 18.1 and was subsequently placed on steroids.His bilirubin and symptoms subsequently improved and he was discharged. Patient eventually underwent a planned outpatient cholecystectomy due to recurrent symptoms with liver biopsy. Biopsy showed chronic cholecysitis and severe steatohepatitis with stage III fibrosis with portal granulomas, consistent with sarcoidosis. The patient eventually was diagnosed to have Child C liver cirrhosis and died from complications of portal hypertension and decompensated liver failure.