Repaglinide is considered a safe drug; adverse events are mild to moderate which includes hypoglycemia, headache, nausea, vomiting, diarrhea and dyspepsia as similar to sulphonylureas. This case report describes a rare side effect of repaglinide. In rare cases, elevated liver enzymes have been noted. We report a case of acute hepatotoxicity in a 78 year old woman who developed acute hepatotoxicity while taking repaglinide.Key Words: hepatotoxicity, hypoglycemia, repaglinide,