Acute liver failure (ALF) is a severe and acute liver injury which presents infrequently. Hepatitis A virus (HAV) occurs commonly in resource poor regions like India. It is one of the commonest cause of acute hepatitis in India, but rarely progressed to ALF. Hypoglycemia in association with liver disease has generally been considered as uncommon entity occurring primarily in circumstances of rapid massive hepatic necrosis. Previous retrospective studies had emphasized rarity of hypoglycemia in viral hepatitis. We present a case of 2 year boy who developed resistant and prolonged hypoglycemia secondary to Hepatitis A induced acute liver failure. Along with difcult to manage hypoglycemia his disease was also complicated with Hepatic encephalopathy and prolonged cholestatic Jaundice. He had a stormy hospital course but survived without Sequelae. We report this case with the aim to raise awareness about this rare but fatal metabolic complication of Hepatitis A infection as viral hepatitis has become a global health-care problem.

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