A case of acute cholestatic hepatitis associated with use of antiplatelet agent ticlopidine is reported. Hepatitis developed 3 weeks after the beginning of the drug in a 72 year old man submitted to coronary angioplasty and stent implantation for unstable angina. The close time relationship between the administration of this antiplatelet drug and the acute onset of liver damage, the exclusion of other hepatobiliary disease and the progressive normalisation of biochemical parameters following withdrawal of the drug strongly suggest that ticlopidine was involved in the pathogenesis of this syndrome.