A 64-year-old woman with hypertension, diabetes mellitus, hyperlipidemia, and history of cholecystectomy presented to the hospital for the evaluation of 4-day history of diffuse abdominal pain. Her home medications were lisinopril, metformin, and liraglutide. She denied alcohol use, illicit drug use, and use of over-the-counter supplements and herbal preparations. On examination, she had epigastric tenderness. She did not exhibit features of liver failure. Her laboratory tests were remarkable for alanine aminotransferase (ALT): 1359 U/L; aspartate aminotransferase (AST): 565 U/L; alkaline phosphatase (ALP): 405 U/L; total bilirubin (TB): 2.9 mg/dL; and INR: 0.9. R factor was consistent with hepatocellular injury. Hepatitis A IgM, hepatitis B surface antigen, hepatitis B surface antibodies, hepatitis B core antibodies and hepatitis C RNA, CMV viral load, and EBV viral load were negative. Immunoglobulin G, antinuclear antibodies, anti-smooth muscle antibodies, antimitochondrial antibodies, anti-liver-kidney microsomal antibodies, ferritin, iron saturation, alpha-1 antitrypsin, ceruloplasmin, and 24-hour urinary copper were normal. Abdominal ultrasound demonstrated fatty changes of the liver, without evidence of biliary obstruction. Her liver tests were normal 6 months prior to presentation, when the patient was started on liraglutide. Due to concern for DILI, liraglutide was discontinued and N-acetylcysteine was administered. On the third day of hospitalization, the patient's symptoms resolved, and her liver tests demonstrated gradual improvement. On the day of discharge, her liver tests were ALT: 335 U/L; AST: 58 U/L; ALP: 286 U/L; and TB: 1.3 mg/dL. 2 months after discharge, her liver tests normalized.