Amiodarone is a class III antiarrhythmic drug used to treat several tachyarrhythmias. Although toxicity by long-term oral therapy is known, it is rare to observe the acute toxicity correlated to intravenous use. We report an unusual case of acute hepatotoxicity after the initiation of intravenous amiodarone for atrial fibrillation in a patient on regular hemodialysis. Liver enzymes progressively decreased and normalized upon discontinuing the drug. As a result, closely monitoring of liver enzyme is suggested when intravenous amiodarone is prescribed.